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- Title
Surgery in adenomyosis.
- Authors
Oliveira, Marco Aurelio Pinho; Crispi, Claudio Peixoto; Brollo, Leila Cristina; De Wilde, Rudy Leon; Crispi, Claudio Peixoto Jr
- Abstract
<bold>Introduction: </bold>Adenomyosis is defined as the presence of endometrial glands and stroma within the myometrium. The true prevalence is unknown and has been reported to range from 1 to 70%. It has a significantly negative impact on women's quality of life, causing abnormal uterine bleeding, dysmenorrhea, and chronic pelvic pain. The definitive treatment for adenomyosis is hysterectomy, although it does not contemplate patients who wish to preserve their fertility. The aim of this paper is to discuss the latest evidence on the surgical techniques for the treatment of adenomyosis published in medical-scientific databases.<bold>Method: </bold>A comprehensive literature search for articles published from 1996 to 2017 related to surgery for adenomyosis was made in Pubmed, Medline, the Cochrane Library, and Google Scholar, in English, by the following MeSH terms: adenomyosis, surgery, pathogenesis, dysmenorrhea and infertility.<bold>Results: </bold>There is extensive evidence on several surgical approaches for the improvement of adenomyosis-related symptoms; however, there is no robust evidence that they are effective for infertility.<bold>Conclusion: </bold>The management of adenomyosis is quite complex and controversial. Complications after extensive uterine reconstruction, such as uterine rupture, should be considered and discussed with the patient. There are still limited data to support surgery effectiveness, especially for infertility, and further well-designed studies are required.
- Subjects
ENDOMETRIOSIS; FEMALE reproductive organ diseases; ENDOMETRIUM; MYOMETRIUM; MYOMETRIUM tumors; ENDOMETRIAL surgery; MYOMETRIUM surgery; DYSMENORRHEA; FERTILITY; GYNECOLOGIC surgery; HYSTERECTOMY; PELVIC pain; QUALITY of life; THERAPEUTICS; UTERUS; UTERINE diseases; THERAPEUTIC embolization; SYSTEMATIC reviews; UTERINE artery; DISEASE complications
- Publication
Archives of Gynecology & Obstetrics, 2018, Vol 297, Issue 3, p581
- ISSN
0932-0067
- Publication type
journal article
- DOI
10.1007/s00404-017-4603-6