Restoration of reproductive function in a patient with extensive diffuse and nodular adenomyosis and large uterine fibroids

Т. А. Макаренко, V.B. Tskhay, D.E. Galkina, S. A. Gukasyan, М.А. Чубко, D.E. Kurskov, Ekaterina Levanova
In: Voprosy ginekologii, akušerstva i perinatologii · 2023 · vol. 22(3) , pp. 129–135 · doi:10.20953/1726-1678-2023-3-129-135 · W4385973827
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An Osada procedure successfully restored reproductive function in a young patient with extensive diffuse and nodular adenomyosis and large uterine fibroids, resulting in a full-term live birth.

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This case report describes the successful management of a young patient presenting with extensive diffuse and nodular adenomyosis alongside large uterine fibroids. The clinical team utilized an organ-preserving surgical approach known as the Osada procedure, which involved simultaneous adenomyomectomy and myomectomy to address both pathologies while preserving fertility. Following the intervention, the patient achieved a full-term live birth, demonstrating that such complex combined lesions can be effectively treated to restore reproductive potential. This paper is centrally about adenomyosis — specifically the surgical excision of diffuse and nodular forms in conjunction with uterine fibroids to enable pregnancy.

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Abstract

The number of young patients with a combination of common uterine proliferative diseases (uterine fibroids, adenomyosis, endometrial hyperplasia) is now increasing in the practice of obstetrician-gynecologist. Treatment of such patients presents considerable difficulties due to the need to preserve fertility. The use of assisted reproductive technologies in these women makes little sense since it is predictably doomed to fail. New organ-preserving surgical techniques are currently available to manage severe forms of diffuse adenomyosis and its combination with uterine fibroids. Organ-preserving surgical treatment gives patients with these pathologies a chance to realize their reproductive potential. This article presents a clinical case of successful surgical treatment of a young patient with diffuse and nodular adenomyosis and several large fibroid nodes using the Osada procedure, which resulted in a full-term live birth. Key words: adenomyosis, adenomyomectomy, pregnancy, uterine fibroids, myomectomy, organ-preserving surgical treatment, delivery
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Restoration of reproductive function in a patient with extensive diffuse and nodular adenomyosis and large uterine fibroids The number of young patients with a combination of common uterine proliferative diseases (uterine fibroids, adenomyosis, endometrial hyperplasia) is now increasing in the practice of obstetrician-gynecologist. Treatment of such patients presents considerable difficulties due to the need to preserve fertility. The use of assisted reproductive technologies in these women makes little sense since it is predictably doomed to fail. New organ-preserving surgical techniques are currently available to manage severe forms of diffuse adenomyosis and its combination with uterine fibroids. Organ-preserving surgical treatment gives patients with these pathologies a chance to realize their reproductive potential. This article presents a clinical case of successful surgical treatment of a young patient with diffuse and nodular adenomyosis and several large fibroid nodes using the Osada procedure, which resulted in a full-term live birth. Key words: adenomyosis, adenomyomectomy, pregnancy, uterine fibroids, myomectomy, organ-preserving surgical treatment, delivery For citation: Makarenko T.A., Tskhay V.B., Galkina D.E., Gukasyan S.A., Chubko M.A., Kurskov D.E., Levanova E.A. Restoration of reproductive function in a patient with extensive diffuse and nodular adenomyosis and large uterine fibroids. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2023; 22(3): 129–135. (In Russian). DOI: 10.20953/1726-1678-2023-3-129-135

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