Uterine-Sparing Laparoscopic Pelvic Plexus Ablation, Uterine Artery Occlusion, and Partial Adenomyomectomy for Adenomyosis

Yang W, Weihong Yang, Liu M, Mingmin Liu, Li Liu, Liu L, Caixia Jiang, Li Chen, Chen L, Qu X, Xiaoyan Qu, Cheng Z, Zhongping Cheng
Journal of Minimally Invasive Gynecology · 2017 · vol. 24(6) , pp. 940–945 · doi:10.1016/j.jmig.2017.04.027 · PMID:28552655 · W2618863035
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This paper describes a surgical technique involving uterine-sparing laparoscopic pelvic plexus ablation, uterine artery occlusion, and partial adenomyomectomy to treat adenomyosis.

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Abstract

Study objectiveTo evaluate safety, feasibility, and long-term clinical effects of adding laparoscopic pelvic plexus ablation to uterine-sparing procedures (uterine artery occlusion and partial adenomyomectomy) for adenomyosis.DesignA prospective controlled study (Canadian Task Force classification II-1).SettingA teaching hospital.PatientsA total of 112 patients with symptomatic adenomyosis were eligible for uterine-sparing laparoscopy.InterventionsLaparoscopic pelvic plexus ablation, uterine artery occlusion, and partial adenomyomectomy.Measurements and main resultsAfter the exclusion of patients with malignant tumors or those lost to follow-up, 102 women underwent laparoscopic uterine artery occlusion and partial adenomyomectomy; 50 of these patients also had laparoscopic uterine pelvic plexus ablation (group A) with the remaining 52 patients serving as the control group (group B). Other than operative time (107.0 ± 15.4 vs 98.9 ± 20.2 minutes, p = .02), there were no statistical differences regarding other operative parameters between groups A and B. Relief of severe dysmenorrhea (Visual Analogue Scale score ≥ 7) at 36 months was higher in group A than in group B (100% vs 76.9%, p < .01). No patient suffered constipation or uroschesis in either group.ConclusionAdding laparoscopic uterine pelvic plexus ablation to laparoscopic uterine artery occlusion and partial adenomyomectomy was more effective in relieving dysmenorrhea.

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Condition tags

dysmenorrheaadenomyosis

MeSH descriptors

Adenomyosis Hypogastric Plexus Laparoscopy Organ Sparing Treatments Uterine Artery Embolization Uterine Myomectomy Adenomyosis Adenomyosis Adult Dysmenorrhea Dysmenorrhea Dysmenorrhea Feasibility Studies Female Fertility Preservation Fertility Preservation Humans Hypogastric Plexus Laparoscopy Middle Aged

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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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License: CC0 · commercial use OK