Clinical Efficacy and Safety of Major Uterine Wall Resection and Reconstruction of the Uterus Combined with LNG-IUS for the Treatment of Severe Adenomyosis

Cui Sun, Xiao-yan Ren, Yi Gao, Zhigang Liang, Zhi-Gang Liang, Meng Mou, Heng‐Fang Gu, Heng-Fang Gu, Yan-Bing Xiao, Yanbing Xiao
Geburtshilfe und Frauenheilkunde · 2019 · vol. 80(03) , pp. 300–306 · doi:10.1055/a-0995-2200 · PMID:32139919 · W2995122988
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Major uterine wall resection and reconstruction combined with LNG-IUS effectively and safely treated severe adenomyosis, eliminating dysmenorrhea and restoring normal uterine volume and CA 125 levels without recurrence.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This study evaluated clinical efficacy and safety of major uterine wall resection and reconstruction of the uterus (MURU) combined with a levonorgestrel-releasing intrauterine system (LNG-IUS) in 90 women diagnosed with adenomyosis, classified by lesion severity using transvaginal ultrasound or MRI measurements (adenomyoma maximum diameter/extent) and baseline CA-125 levels. Women underwent conventional laparotomy with MURU and LNG-IUS placement, and outcomes included dysmenorrhea and menstrual blood volume changes, uterine volume, CA-125 at 3, 6, and 12 months, plus intraoperative and hospitalization safety measures. All 90 patients completed treatment without significant surgical or hospital complications, dysmenorrhea completely disappeared in all, uterine volume and CA-125 normalized, and no adenomyosis recurrence was observed during follow-up. The paper does not report a control or comparison group, which limits attribution of effects specifically to this combined approach. This paper is centrally about endometriosis and/or adenomyosis — it focuses on adenomyosis treatment using MURU combined with LNG-IUS for severe disease.

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Abstract

Abstract Objective Aim of the study was to evaluate the clinical efficacy and safety of major uterine wall resection and reconstruction of the uterus (MURU) combined with a levonorgestrel-releasing intrauterine system (LNG-IUS) for the treatment of adenomyosis. Methods Ninety patients diagnosed with adenomyosis were enrolled in this study. All participants were examined by transvaginal ultrasound (TVU) or magnetic resonance imaging (MRI). Serum levels of cancer antigen 125 (CA 125) were quantitatively measured. All patients underwent MURU in combination with LNG-IUS. The therapeutic safety of MURU was assessed during surgery and the patientsʼ stay in hospital. The clinical efficacy was evaluated by comparatively analyzing changes in dysmenorrhea, volume of menstrual blood, uterine volume and serum levels of CA 125 before, and at 3, 6 and 12 months following MURU. Results All 90 patients enrolled in the study were successfully treated with MURU combined with LNG-IUS. No significant complications were observed during surgery and hospital stay. The mean operation time, intraoperative blood loss and length of hospital stay were 82.4 ± 13.8 min, 53.3 ± 20.3 ml, and 4.3 ± 0.8 days, respectively. Dysmenorrhea completely disappeared in all patients. Uterine volume and serum levels of CA 125 were restored to normal ranges. No recurrence of adenomyosis was observed during postoperative follow-up. Conclusion MURU combined with LNG-IUS is an efficacious and safe treatment for severe adenomyosis. This combined technique is not only effective to manage severe adenomyosis but also preserves as much of the uterus as possible.

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adenomyosisdysmenorrhea

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