Biopsy diagnosis and conservative surgical treatment of adenomyosis

Carl Wood, C Wood, Wood C, Maher P, Peter Maher, P. Maher, D Hill, Hill D, David J. Hill
The Journal of the American Association of Gynecologic Laparoscopists · 1994 · vol. 1(4) , pp. 313–316 · doi:10.1016/s1074-3804(05)80794-7 · PMID:9138870 · W2129639009
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This paper reviews biopsy diagnosis and conservative surgical treatment approaches for adenomyosis.

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Abstract

STUDY OBJECTIVE: To diagnose adenomyosis by vaginal ultrasound and percutaneous or transcervical myometrial biopsy, and use the results to choose treatment and assess prognosis. DESIGN: Evaluation of 31 consecutive women referred by other physicians. SETTING: A private gynecologic practice. PATIENTS: The women had menstrual symptoms that had not responded to medical treatment or uterine curettage. INTERVENTIONS: Myometrial diagnosis was made by percutaneous ultrasound-guided needle biopsy, by transcervical electrosurgical loop biopsy at the time of endometrial resection, or by needle biopsy at the time of laparoscopy or laparotomy. Endometrial resection was performed in 15 patients, laparoscopic myometrial reduction in 7, and excision of adenomyotic myometrium or localized adenomyoma in 8. MEASUREMENTS AND MAIN RESULTS: Cure was defined as relief of menorrhagia and dysmenorrhea. Endometrial resection cured menorrhagia in 12 of 15 patients but dysmenorrhea in only 3 of 8; myometrial excision cured 7 of 8, and myometrial reduction 4 of 7 women. CONCLUSIONS: Vaginal ultrasound combined with transabdominal or transcervical myometrial biopsy established the diagnosis of adenomyosis in all patients. Endometrial resection and myometrial reduction or excision reduced the need for hysterectomy to 30% in these women.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Endometriosis Uterine Diseases Uterine Diseases Adult Adult Biopsy, Needle Biopsy, Needle Biopsy, Needle Biopsy, Needle Electrosurgery Electrosurgery Endometriosis Endometriosis Endometriosis Evaluation Studies as Topic Evaluation Studies as Topic Female Female Follow-Up Studies

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (25)

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License: CC0 · commercial use OK