Adenomyosis and endometriosis

Endometriosis is a common gynecological condition seen frequently in reproductive-age women. Presence of endometrial glands outside the endometrium is defined as endometriosis, while occurrence of endometrial glands and stroma within the myometrium, associated with myohyperplasia and hypertrophy, is known as adenomyosis. Adenomyosis is an enigmatic gynecological condition, with its diagnosis and management always being a great challenge to physicians. Plan of management needs to be individualized depending upon the symptoms and desire for further conception; after completion of child bearing, hysterectomy is the only definitive treatment for adenomyosis; however, conservative treatment is also required for women desirous to conceive and in need of symptomatic relief. This chapter discusses etiopathogenesis, classification, diagnosis, and various medical as well as surgical therapies for adenomyosis. Details of surgical techniques such as partial adenomyosis excision (laparotomy/laparoscopic), complete adenomyosis excision, and laparoscopic surgery for adenomyosis, along with postsurgery results, have been described in the chapter. Conservative surgical treatment for adenomyosis may be an efficacious alternative to infertile women who fail to conceive after adequate treatment of infertility; however, supporting literature is still suboptimal.