{"paper_id":"f0ee5301-e30b-4a7a-8103-d8e11240fcb8","body_text":"International Journal of Science and Research (IJSR)\n \nISSN: 2319\n-\n7064\n \nSJIF (2022): 7.942\n \nVolume 13 Issue 9, September 2024\n \nFully Refereed | Open Access | Double Blind \nPeer Reviewed Journal\n \nwww.ijsr.net\n \nNavigating\n \nAdenomyosis\n: \nA\n \nCase\n \nSeries\n \non\n \nUterus\n \n-\n \nConserving\n \nAdenomyomectomy\n \nfor\n \nEnhanced\n \nClinical\n \nInsights\n \n \nDr\n.\n \nDulumoni\n \nBorah\n1\n, Dr\n.\n \nLalita N Mayadeo\n2\n, Dr\n.\n \nKomal N Chavan\n3\n, Dr\n.\n \nShweta Kashikar\n4\n \n \n1\nSenior Resident, Department of\n \nObstetrics & Gynaecology, V N Desai Municipal General Hospital, Santacruz East Mumbai 400055, \nMobile no 8591115392\n \nEmail: \ndulumoni2468[at]gmail.com\n; \ndulumonisd19999[at]gmail.com\n \n \n2\nSenior Consultant & Head of Department, Department of Obstetrics & Gynaecology, V N Desai Municipal General Hospital\n \n \n3\nSenior Consultant, Department of\n \nObstetrics & Gynaecology, V N Desai Municipal General Hospital\n \n \n4\nJunior Consultant, Department of Obstetrics & Gynaecology, V N Desai Municipal General Hospital\n \n \n \nAbstract\n:\n \nDiffuse\n \nadenomyosis\n \nposes\n \na\n \nchallenging\n \nclinical\n \nscenario\n \ndue\n \nto\n \nits\n \nwidespread\n \ninfiltration\n \nwithin\n \nthe\n \nuterine\n \nwall\n, \noften\n \nleading\n \nto\n \nsymptomatic\n \nmanifestations\n \nand\n \nimpacting\n \nfertility\n. \nThis\n \nabstract\n \nexplores\n \nthe\n \nefficacy\n \nand\n \noutcomes\n \nof\n \nconservative\n \nsurgery\n, \nspecifically\n \nadenomyomectomy\n, \nas\n \na\n \nuterus\n \n-\n \nsaving\n \napproach\n \nin\n \nmanaging\n \ndiffuse\n \nadenomyosis\n. \nThe\n \nstudy\n \nreviews\n \na\n \ncohort\n \nof\n \npatients\n \ndiagnosed\n \nwith\n \ndiffuse\n \nadenomyosis\n \nwho\n \nunderwent\n \nconservative\n \nsurgery\n \naimed\n \nat\n \nexcising\n \nadenomyotic\n \nlesions\n \nwhile\n \npreserving\n \nthe\n \nintegrity\n \nof\n \nthe\n \nuterus\n. \nVarious\n \nsurgical\n \ntechniques\n \nand\n \napproaches\n \nare\n \nanalyzed\n, \nconsidering\n \ntheir\n \nimpact\n \non\n \nsymptom\n \nrelief\n, \nreproductive\n \noutcomes\n, \nand\n \npostoperative\n \ncomplications\n. \nPreliminary\n \nfindings\n \nsuggest\n \nthat\n \nconservative\n \nadenomyomectomy\n \ncan\n \nbe\n \na\n \nviable\n \noption\n \nfor\n \npatients\n \nseeking\n \nto\n \nretain\n \ntheir\n \nuterus\n \nwhile\n \naddressing\n \nthe\n \nsymptomatic\n \nburden\n \nof\n \ndiffuse\n \nadenomyosis\n. \nThe\n \nstudy\n \nemphasizes\n \nthe\n \nimportance\n \nof\n \nmeticulous\n \nsurgical\n \nplanning\n, \nintraoperative\n \nprecision\n, \nand\n \npatient\n \nselection\n \nfor\n \noptimal\n \noutcomes\n. \nThis\n \nabstract\n \ncontributes\n \nvaluable\n \ninsights\n \ninto\n \nthe\n \nevolving\n \nlandscape\n \nof\n \nadenomyosis\n \nmanagement\n, \nhighlighting\n \nthe\n \npotential\n \nof\n \nconservative\n \nsurgery\n \nas\n \na\n \nuterus\n \n-\n \npreserving\n \nstrategy\n \nfor\n \nthose\n \nfacing\n \nthe\n \nchallenges\n \nof\n \ndiffuse\n \nadenomyosis\n. \n \n \nKeywords\n:\n \nAdenomyosis\n, \nadenomyomectomy\n, \nconservative\n \nsurgery\n, \nuterus\n \npreserving\n \nstrategy\n \n \n1.\n \nIntroduction\n \n \nAdenomyosis\n \nis\n \nuterine\n \nthickening\n \nthat\n \noccurs\n \nwhen\n \nendometrial\n \ntissue\n, \nwhich\n \nnormally\n \nlines\n \nthe\n \nuterus\n, \nmoves\n \ninto\n \nthe\n \nouter\n \nmuscular\n \nwalls\n \nof\n \nthe\n \nuterus\n. \nThe\n \nadvised\n \ntreatment\n \nfor\n \nthe\n \nsevere\n \nforms\n \nof\n \nadenomyosis\n \nis\n \nhysterectomy\n \n[\n1]\n \n(\nremoval\n \nof\n \nthe\n \npatient’s\n \nuterus\n), \nbut\n \nfor\n \nthe\n \npatient\n \nwho\n \nwishes\n \nto\n \npreserve\n \nher\n \nuterus\n, \na\n \nnovel\n \nconservative\n \nsurgery\n \nreferred\n \nto\n \nas\n \n‘adenomyomectomy’\n \n(\nremoval\n \nof\n \nthe\n \nabnormal\n \ntissues\n) \ncan\n \nbe\n \nperformed\n \n[\n2]\n. \nThis\n \ntechnique\n \nmust\n \nbe\n \ndeveloped\n \nfor\n \nreduction\n \nof\n \nspontaneous\n \nuterine\n \nrupture\n, \nadhesions\n \nand\n \nrecurrence\n \nrate\n \n[\n2]\n. \nThis\n \nstudy\n \naims\n \nto\n \ninvestigate\n \nthe\n \nsafety\n \nand\n \ntherapeutic\n \noutcomes\n \nof\n \nadenomyomectomy\n. \nBecause\n \nof\n \nthe\n \npathogenesis\n \nof\n \nadenomyosis\n, \nsurgical\n \ntreatment\n \nby\n \nadenomyomectomy\n \nmust\n \ninvolve\n \nthe\n \nresection\n \nof\n \nall\n \nthe\n \naltered\n \ntissues\n, \nleave\n \nthe\n \nthin\n \nhealthy\n \nmyometrium\n \nintact\n, \nreconstruct\n \nthe\n \nuterus\n \nin\n \na\n \nspecific\n \nmanner\n \nwith\n \nthe\n \nlowest\n \ndegree\n \nof\n \nadhesion\n \nand\n \nensure\n \nthat\n \nthe\n \nsutures\n \nallow\n \nfor\n \nefficient\n \nblood\n \nsupply\n \nfor\n \nthe\n \nrepair\n. \nDecreasing\n \nischaemia\n \nin\n \nthe\n \nendometrium\n \nby\n \nremoval\n \nof\n \nthe\n \nfibrosis\n \ntissue\n \nis\n \nthe\n \nmajor\n \npurpose\n \nof\n \nthe\n \nsurgical\n \nmethod\n. \n \n \nThe\n \naim\n \nof\n \nthis\n \nstudy\n \nis\n \nto\n \ninvestigate\n \nthe\n \nsafety\n \nand\n \ntherapeutic\n \noutcomes\n \nof\n \na\n \ndifferent\n \nadenomyomectomy\n \ntechnique\n \nwith\n \nthe\n \nabove\n \ncharactuteruseristics\n. \nThe\n \naim\n \nis\n \nto\n \nintroduce\n \nthis\n \nsurgical\n \ntechnique\n \nas\n \nan\n \nalternative\n \ntreatment\n \noption\n \nto\n \nhysterectomy\n \nfor\n \nuterine\n \nadenomyosis\n, \nspecifically\n \nfor\n \nthe\n \npatient\n \nwho\n \nwishes\n \nto\n \npreserve\n \nher\n \nuterus\n \nand\n \nperhaps\n \nhave\n \na\n \nchild\n \nin\n \nfuture\n. \n \n \nCase\n \nSeries 1\n \n \nA\n \n33\n \nyears\n \nold\n \nfemale\n \nP1L1\n \ncomplained\n \nof\n \ndysmenorrhoea\n \nand\n \nlower\n \nabdominal\n \npain\n \nalong\n \nwith\n \nheavy\n \nmenstrual\n \nbleeding\n \nsince\n \nlast\n \n1\n \nyear\n \nwas\n \nplanned\n \nfor\n \nmyomectomy\n. \nPatient\n \nwas\n \ngiven\n \nmedical\n \nmanagement\n \nprior\n \nto\n \nthat\n \nfor\n \n3\n \nmonths\n \nbut\n \nsymptoms\n \ndid\n \nnot\n \nget\n \nsubsided\n. \nUSG\n \nsuggestive\n \nof\n \nmyoma\n \nof\n \nsize\n \n6\n.6\n*7*6\n.6 \ncm\n \nin\n \nposterior\n \nwall\n \nof\n \nuterus\n. \nPer\n \nvaginally\n \nuterus\n \nwas\n \n14\n \n-\n \n16\n \nweek\n \nsize\n \nwith\n \nfirm\n \nto\n \nsoft\n \nin\n \nconsistency\n \nwith\n \nno\n \nany\n \nseparate\n \nmass\n \nfeel\n \nin\n \nthe\n \nadnexa\n \nand\n \nmobility\n \nof\n \nuterus\n \nwas\n \nunrestricted\n. \nIntraoperatively\n, \nhowever\n \nthere\n \nwas\n \nno\n \nclear\n \nsurgical\n \nplane\n \nor\n \nwhitish\n \nwhorled\n \nappearance\n \nof\n \nfibroid\n, \nposterior\n \nwall\n \nof\n \nuterus\n \nwas\n \nsymmetrically\n \nenlarged\n \nand\n \ndiagnosis\n \nof\n \nadenomyosis\n \nis\n \nmade\n. \n \n \nCase\n \nSeries \n2\n \n \nA\n \n34\n \nyrs\n \nold\n \nfemale\n \nP1\n \nL1\n \nwith\n \nhuge\n \nadenomyoma\n \nof\n \nsize\n \n11\n.4\n*\n \n9\n.9\n*10\n.4 \ncm\n \nin\n \nposterior\n \nwall\n \nof\n \nuterus\n \nin\n \nUSG\n \nwas\n \nevaluated\n \nivo\n \nlower\n \nabdominal\n \npain\n \nand\n \ndysmenorrhoea\n \nsince\n \nlast\n \n6\n \n-\n \n7\n \nyears\n. \nMRI\n \nconfirmed\n \ndiagnosis\n \nof\n \nadenomyoma\n. \n \n \nPatient\n \nwas\n \ninitially\n \nwas\n \ntreated\n \nwith\n \nLNG\n \nIUS\n \nbut\n \nsymptoms\n \ndid\n \nnot\n \nsubsided\n \nwith\n \nmedical\n \nmanagement\n \n \nPer\n \nabdomen\n \nmass\n \nof\n \nsize\n \n14\n \n-\n \n16\n \nweeks\n \nfelt\n \nwith\n \nside\n \nto\n \nside\n \nmobility\n \nbut\n \nrestricted\n \nfrom\n \nabove\n \ndownwards\n \nnot\n \nseparated\n \nfrom\n \nuterus\n. \nPer\n \nvaginally\n \ncervix\n \nwas\n \npulled\n \nup\n. \n \n \nPaper ID: SR24916211831\nDOI: https://dx.doi.org/10.21275/SR24916211831\n1324 \n\nInternational Journal of Science and Research (IJSR)\n \nISSN: 2319\n-\n7064\n \nSJIF (2022): 7.942\n \nVolume 13 Issue 9, September 2024\n \nFully Refereed | Open Access | Double Blind \nPeer Reviewed Journal\n \nwww.ijsr.net\n \nPatient\n \nwas\n \nposted\n \nfor\n \nadenomyomectomy\n \nand\n \nintraopeatively\n \n7*6*7\n \ncm\n \nadenomyotic\n \ntissue\n \nremoved\n \n \nCase\n \nS\neries\n \n3\n \n \nA\n \n37\n \nyears\n \nold\n \nnulligravida\n \nwith\n \na\n \nhistory\n \nof\n \nprimary\n \ninfertility\n \ncomplained\n \nof\n \nheavy\n \nmenstrual\n \nbleeding\n \nand\n \ndysmenorrhoea\n \nsince\n \nlast\n \n6\n \n-\n \n7\n \nmonths\n. \n \n \nPatient\n \ntook\n \nmedical\n \nmanagement\n \nwith\n \nantifibrinolytics\n \nand\n \nprogesterone\n \ntherapy\n \nfor\n \n3\n \n-\n \n4\n \nmonths\n \nbut\n \nsymptoms\n \ndidnot\n \nget\n \nsubsided\n. \n \n \nMRI\n \nwas\n \nsuggestive\n \nof\n \nposterior\n \nwall\n \nadenomyoma\n \nof\n \nsize\n \n7\n.2\n*7*7\n.1 \ncm\n. \n \n \nPer\n \nvaginally\n \nuterus\n \nwas\n \naround\n \n10\n \n-\n \n12\n \nweeks\n \nsize\n \n \nPatient\n \nposted\n \nfor\n \nadenomyomectomy\n. \nIntraoperatively\n \naround\n \n6*7*7\n \ncm\n \nadenomyotic\n \ntissue\n \nremoved\n. \n \n \n2.\n \nSurgical Technique\n \n \nThe\n \nsurgical\n \nprocedure\n \nconsists\n \nof\n \nradical\n \nexcision\n \nof\n \nadenomyosis\n \n(\nleaving\n \na\n \n1\n \ncm\n \nmargin\n \nof\n \ntissue\n \nabove\n \nthe\n \nendometrium\n \nand\n \na\n \n1\n \ncm\n \nmargin\n \nof\n \ntissue\n \nbelow\n \nthe\n \nserosal\n \nsurface\n), \nwith\n \nsubsequent\n \ntriple\n \n-\n \nflap\n \nreconstruction\n \nof\n \nthe\n \nuterus\n. \n \n \nIn\n \nthe\n \nuterus\n,. \ninj\n \nvasopressin\n \nwas\n \ninjected\n. \n \n \nThe\n \nenlarged\n \nuterus\n \nis\n \nbisected\n \nfrom\n \nthe\n \nserosal\n \nsurface\n \nof\n \nthe\n \nfundus\n, \nin\n \nthe\n \nmidline\n \nand\n \nin\n \nthe\n \nsagittal\n \nplane\n, \nall\n \nthe\n \nway\n \ndown\n \nthrough\n \nthe\n \nadenomyosis\n \nuntil\n \nthe\n \nuterine\n \ncavity\n \nis\n \nreached\n. \n \n \nIn\n \nthis\n \nway\n \nthe\n \nentire\n \nextent\n \nof\n \nthe\n \nadenomyosis\n \nis\n \nclearly\n \nvisible\n, \nt\nhe\n \nendometrial\n \ncavity\n \nis\n \nopened\n \nsufficiently\n \nto\n \npermit\n \nthe\n \nintroduction\n \nof\n \nthe\n \nindex\n \nfinger\n \nto\n \nprotect\n \nand\n \nhelp\n \nguide\n \nduring\n \nexcision\n \nof\n \nthe\n \nadenomyotic\n \ntissues\n. \n \n \n \nThe\n \nadenomyotic\n \ntissues\n \nare\n \nexcised\n \nfrom\n \nsurrounding\n \nmyometrium\n \nleaving\n \na\n \nmyometrial\n \nthickness\n, \nfrom\n \nthe\n \nserosa\n \nabove\n \nand\n \nthe\n \nendometrium\n \nbelow\n, \nof\n \n1\n \ncm\n. \nCare\n \nis\n \nalso\n \ntaken\n \nto\n \navoid\n \ndamage\n \nto\n \nthe\n \nFallopian\n \ntubes\n. \n \n \nThe\n \nendometrial\n \nlining\n \nis\n \nthen\n \napproximated\n \nwith\n \ninterrupted\n \nsutures\n \nof\n \n3\n–\n0\n \nVicryl\n. \n \n \nThereafter\n, \nthe\n \nmyometrial\n \ndefect\n \nclosed\n \nwith\n \nthe\n \ntriple\n \n-\n \nflap\n \noverlap\n \nmethod\n \n[\n1]\n, \nwith\n \ncare\n \nbeing\n \ntaken\n \nto\n \navoid\n \noverlapping\n \nsuture\n \nlines\n. \nThe\n \nuterus\n \nis\n \nreconstructed\n \nin\n \nthe\n \nfollowing\n \nmanner\n. \n \n \nOn\n \none\n \nside\n \nof\n \nthe\n \nbisected\n \nuterus\n \nthe\n \nmyometrium\n \nand\n \nserosa\n \nare\n \napproximated\n \nin\n \nthe\n \nantero\n \n-\n \nposterior\n \nplane\n \nwith\n \nmany\n \ninterrupted\n \nsutures\n \nof\n \n2\n–\n0\n \nVicryl\n. \n \n \nThen\n \nthe\n \ncontralateral\n \nside\n \nof\n \nthe\n \nuterine\n \nwall\n \n(\ncomposed\n \nalso\n \nof\n \nserosa\n \nand\n \nmyometrium\n) \nis\n \nbrought\n \nover\n \nthe\n \nreconstructed\n \nfirst\n \nside\n \nin\n \nsuch\n \na\n \nway\n \nas\n \nto\n \ncover\n \nthe\n \nseromuscular\n \nsuture\n \nline\n. \n \n \n \nSuture\n \nlines\n \nmust\n \nnot\n \noverlap\n; \nonly\n \nmyometrial\n \ntissue\n \nflaps\n \noverlap\n. \nThe\n \nmyometrium\n \nof\n \nthe\n \nunderlying\n \nflap\n \nmust\n \nbe\n \ndenuded\n \nof\n \nserosa\n. \n \n \nRemarkably\n, \nthere\n \nis\n \nno\n \nsignificant\n \nbleeding\n \nbecause\n \nof\n \nthe\n \ntissue\n \npressure\n \ncreated\n \nby\n \nthe\n \nreconstruction\n. \n \n \n \n \n \nFigure\n \n1\n:\n \nS\ntepwise\n \nprocedure\n \nof\n \nadenomyomectomy\n \nwith\n \ntriple\n \nflap\n \noverlap\n \nmethod\n \nPaper ID: SR24916211831\nDOI: https://dx.doi.org/10.21275/SR24916211831\n1325 \n\nInternational Journal of Science and Research (IJSR)\n \nISSN: 2319\n-\n7064\n \nSJIF (2022): 7.942\n \nVolume 13 Issue 9, September 2024\n \nFully Refereed | Open Access | Double Blind \nPeer Reviewed Journal\n \nwww.ijsr.net\n \nPost\n \n-\n \noperative\n \ncourse\n \nPost\n \n-\n \noperative\n \nperiod\n \nwas\n \nuneventful\n. \n \n \nThe\n \nremoved\n \ntissues\n \nwere\n \nconfirmed\n \nby\n \nhistopathological\n \nassay\n. \n \n \nSymptoms\n \nof\n \ndysmenorrhoea\n \nand\n \nheavy\n \nmenstrual\n \nbleeding\n \nsignificantly\n \nreduced\n \non\n \nvisual\n \nanalogue\n \nscale\n \nscore\n \nof\n \n1\n \n-\n \n10\n. \n \n \nPost\n \n-\n \noperatively\n, \nafter\n \ndischarge\n \nfrom\n \nthe\n \nhospital\n, \nthe\n \npatients\n \nwere\n \ninitially\n \nfollowed\n \nmonthly\n \nfor\n \n6\n \nmonths\n \nand\n \nsubsequently\n \nevery\n \n2\n–\n3\n \nmonths\n. \n \n \nFor\n \nthe\n \nfirst\n \n6\n \nmonths\n, \nthe\n \nuterine\n \nblood\n \nflow\n \nwas\n \nchecked\n \nmonthly\n \nwith\n \nendovaginal\n \nultrasonography\n \nwith\n \ncolour\n \nDoppler\n \nimaging\n \nand\n \nwith\n \ncontrast\n \n-\n \nenhanced\n \nMRI\n \nevery\n \n3\n \nmonths\n. \n \n \nUterine\n \nblood\n \nflow\n \nin\n \nthe\n \noperated\n \narea\n \ngenerally\n \nreturned\n \nto\n \nnormal\n \nwithin\n \n6\n \nmonths\n \nand\n \npost\n \n-\n \noperative\n \nMRI\n \nappeared\n \nremarkably\n \nnormal\n. \n \n \n \n \nFigure\n \n2\n:\n \nUSG\n \nshowing\n \npre\n \nand\n \npost\n \n-\n \noperative\n \ncase\n \nof\n \nadenomyomectomy\n \n \n3.\n \nDiscussion\n \n \nThis\n \nstudy\n \nshows\n \nthat\n \nadenomyomectomy\n \ncan\n \nbe\n \na\n \nconservative\n \nand\n \neffective\n \noption\n \nto\n \ntreat\n \nadenomyosis\n, \nespecially\n \nin\n \nwomen\n \nwho\n \nseek\n \nuterine\n \nand\n \nfertility\n \npreservation\n. \nSevere\n \nadenomyosis\n \ncauses\n \ninfertility\n, \nsevere\n \ndysmenorrhea\n \nand\n \nhypermenorrhoea\n \n[\n1]\n \n[\n4]\n. \nUncertainty\n \nin\n \ndefining\n \nthe\n \nsite\n \nand\n \nextent\n \nowing\n \nto\n \na\n \nlack\n \nof\n \nsurgical\n \nplane\n \nmakes\n \nit\n \ndifficult\n \nto\n \ndetermine\n \nthe\n \nextent\n \nof\n \ncomplete\n \nexcision\n \n[\n3]\n. \nOne\n \nconstantly\n \nneeds\n \nto\n \nbalance\n \nbetween\n \ninadequate\n \nremoval\n \nof\n \nthe\n \nadenomyoma\n \nversus\n \nexcessive\n \nhealthy\n \nmyometrial\n \nexcision\n \nthat\n \nis\n \ndetrimental\n \nto\n \nwound\n \nintegrity\n \n[\n3]\n. \nThe\n \nrationale\n \nfor\n \nadenomyomectomy\n \nincludes\n \nthat\n \nof\n \ncytoreduction\n, \ndebulking\n \nto\n \nrelieve\n \nthe\n \nmechanical\n \ndisturbances\n, \nand\n \ncorrecting\n \nphysiological\n \ndisturbances\n \nthat\n \nmay\n \nimpair\n \nsperm\n \ntransport\n \n[\n3]\n. \nThe\n \nprocedure\n \ndescribed\n \nin\n \nthis\n \nstudy\n \ncan\n \nbe\n \nan\n \nefficient\n \nprocedure\n \nto\n \ntreat\n \nsevere\n \nadenomyosis\n. \nThis\n \nmethod\n \ncan\n \nbe\n \nfurther\n \nmodified\n \nfor\n \nbetter\n \noutcomes\n \nand\n \nthis\n \nstudy\n \ncentre\n \nis\n \nattempting\n \nto\n \ndevelop\n \nsafer\n \nand\n \nless\n \ninvasive\n \nmethods\n \nto\n \npromote\n \nthe\n \nmanagement\n \nof\n \nadenomyosis\n. \n \n \nReferences\n \n \n[1]\n \nSurgical\n \nprocedure\n \nto\n \nconserve\n \nthe\n \nuterus\n \nfor\n \nfuture\n \npregnancy\n \nin\n \npatients\n \nsuffering\n \nfrom\n \nmassive\n \nadenomyosis\n \nHisao\n \nOsada\n \net\n \nal\n. \nPublished\n: \nOctober\n \n06\n, \n2010DOI\n: \nhttps\n: \n//\ndoi\n. \norg/10\n.1\n016/j\n. \nrbmo\n.2\n010\n.0\n9\n.0\n14\n \n[2]\n \nTreatment\n \nof\n \nadenomyomectomy\n \nin\n \nwomen\n \nwith\n \nsevere\n \nuterine\n \nadenomyosis\n \nusing\n \na\n \nnovel\n \ntechnique\n \nAboTaleb\n \nSaremi\n \net\n \nal\n \nPublished\n: \nMarch\n \n06\n, \n2014DOI\n: \nhttps\n: \n//\ndoi\n. \norg/10\n.1\n016/j\n. \nrbmo\n.2\n014\n.0\n2\n.0\n08\n \n[3]\n \nApproaches\n \nto\n \nadenomyomectom\n \nSerene\n \nThain\n \net\n \nal\n \nhttps\n: \n//\ndoi\n. \norg/10\n.1\n016/j\n. \ngmit\n.2\n014\n.0\n8\n.0\n06\n \n[4]\n \nMedical\n \nand\n \nsurgical\n \nmanagement\n \nof\n \nadenomyosis\n \nCynthia\n \nFarquhar\n \nMBChB\n, \nMD\n, \nFRANZCOG\n, \nCREI\n, \nMPH\n \n(\nPostgraduate\n \nProfessor\n \nof\n \nObstetrics\n \nand\n \nGynaecology\n), \net\n \nal\n \nhttps\n: \n//doi\n. \norg/10\n.1\n016/j\n. \nbpobgyn\n.2\n006\n.0\n1\n.0\n12\n \n \nPaper ID: SR24916211831\nDOI: https://dx.doi.org/10.21275/SR24916211831\n1326","source_license":"CC0","license_restricted":false}