The Surgical Treatment of Adenomyosis

In: Adenomyosis · 2021 · pp. 99–111 · doi:10.1007/978-981-33-4095-4_11 · W3131658533
book-chapter OA: closed CC0 ⤵ 1 in-corpus citation
Full text JSON View on OpenAlex View at publisher
AI-generated summary by claude@2026-06+body, 2026-06-07

This chapter discusses the surgical treatment of adenomyosis, focusing on conservative approaches for symptomatic relief, fertility preservation, and pregnancy outcomes, as hysterectomy is definitive but undesirable for fertility.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text

This chapter reviews surgical management options for adenomyosis, focusing on conservative (uterus-sparing) procedures for long-term symptom control and fertility preservation, and also discusses pregnancy outcomes after conservative surgery. It situates adenomyosis as a benign condition with abnormal uterine bleeding, dysmenorrhea, and chronic pelvic pain, noting that while hysterectomy is the definitive treatment, many patients seek alternatives and that there are no international guidelines guiding surgical or medical therapy. The chapter highlights “hot issues” such as the effectiveness of conservative surgery for symptomatic relief and its reproductive implications, while acknowledging the broader need for long-term management plans that address pain and bleeding as well as fertility-related goals. This paper is centrally about endometriosis and adenomyosis—though it is a general surgical treatment review focused specifically on adenomyosis, it explicitly compares adenomyosis to endometriosis in framing treatment concerns.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Full text 9,243 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Abstract

Adenomyosis has a significantly negative impact on women’s quality of life, causing abnormal uterine bleeding, dysmenorrhea, and chronic pelvic pain [1, 2]. Like endometriosis, adenomyosis is a benign disease, and although the definitive treatment of adenomyosis is hysterectomy, it is against many patients’ desire to retain fertility. At present, there are currently no international guidelines to follow for either surgical or medical treatment for adenomyosis. But there is a growing consensus that adenomyosis needs long-term management plans, including pain and bleeding control, fertility preservation, and pregnancy assistance. In this context, the effect of conservative surgical treatment for long-term symptomatic relief, the benefit from the uterus-sparing surgery, and the pregnancy outcome after conservative surgery have become hot issues in the clinical treatment of adenomyosis. This chapter will discuss the surgical treatment of adenomyosis. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Osada H. Uterine adenomyosis and adenomyoma: the surgical approach. Fertil Steril. 2018;109(3):406–17. Oliveira MAP, et al. Surgery in adenomyosis. Arch Gynecol Obstet. 2018;297(3):581–9. Osuga Y, Watanabe M, Hagino A. Long-term use of dienogest in the treatment of painful symptoms in adenomyosis. J Obstet Gynaecol Res. 2017;43(9):1441–8. Li L, et al. Treatment of symptomatic adenomyosis with the levonorgestrel-releasing intrauterine system. Int J Gynaecol Obstet. 2019;146(3):357–63. Pontis A, et al. Adenomyosis: a systematic review of medical treatment. Gynecol Endocrinol. 2016;32(9):696–700. Van Praagh I. Conservative surgical treatment for adenomyosis uteri in young women: local excision and metroplasty. Can Med Assoc J. 1965;93(22):1174–5. Rocha TP, et al. Fertility-sparing treatment of Adenomyosis in patients with infertility: a systematic review of current options. Reprod Sci. 2018;25(4):480–6. Cunningham RK, et al. Adenomyosis: a sonographic diagnosis. Radiographics. 2018;38(5):1576–89. Sam M, et al. Accuracy of findings in the diagnosis of uterine adenomyosis on ultrasound. Abdominal Radiology. 2020;45(3):842–50. Andres MP, et al. Transvaginal ultrasound for the diagnosis of adenomyosis: systematic review and meta-analysis. J Minim Invasive Gynecol. 2018;25(2):257–64. Van den Bosch T, et al. Sonographic classification and reporting system for diagnosing adenomyosis. Ultrasound Obstet Gynecol. 2019;53(5):576–82. Kishi Y, et al. Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification. Am J Obstet Gynecol. 2012;207(2):114–e1-114. e7. Lazzeri L, et al. A sonographic classification of adenomyosis: interobserver reproducibility in the evaluation of type and degree of the myometrial involvement. Fertil Steril. 2018;110(6):1154–1161. e3. Tellum T, et al. Development of a clinical prediction model for diagnosing adenomyosis. Fertil Steril. 2018;110(5):957–964.e3. Champaneria R, et al. Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy. Acta Obstet Gynecol Scand. 2010;89(11):1374–84. Bazot M, Daraï E. Role of transvaginal sonography and magnetic resonance imaging in the diagnosis of uterine adenomyosis. Fertil Steril. 2018;109(3):389–97. Kroencke TJ. MRI for diagnosis of adenomyosis: unsung and underutilized. Gynecol Obstet Investig. 2005;60(3):154. Agostinho L, et al. MRI for adenomyosis: a pictorial review. Insights Imaging. 2017;8(6):549–56. Bazot M, et al. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Hum Reprod. 2001;16(11):2427–33. Lee J, et al. Single-port access versus conventional multi-port access total laparoscopic hysterectomy for very large uterus. Obstet Gynecol Sci. 2015;58(3):239–45. Song T, et al. Single port access laparoscopic-assisted vaginal hysterectomy for large uterus weighing exceeding 500 grams: technique and initial report. J Minim Invasive Gynecol. 2010;17(4):456–60. Baekelandt J, et al. Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day-care procedure: a randomised controlled trial. BJOG Int J Obstet Gynaecol. 2019;126(1):105–13. Sasaki KJ, et al. Persistent bleeding after laparoscopic supracervical hysterectomy. JSLS: J Soc Laparoendoscopic Surg. 2014;18(4) Sokol AI, Green IC. Laparoscopic hysterectomy. Clin Obstet Gynecol. 2009;52(3):304–12. Pepas L, Deguara C, Davis C. Update on the surgical management of adenomyosis. Curr Opin Obstet Gynecol. 2012;24(4):259–64. Kim SH, et al. Postoperative outcomes of natural orifice transluminal endoscopic surgery-assisted vaginal hysterectomy and conventional laparoscopic-assisted vaginal hysterectomy: a comparative study. Obstet Gynecol Sci. 2018;61(2):261–6. Saito A, et al. Preoperative assessment of factors associated with difficulty in performing total laparoscopic hysterectomy. J Obstet Gynaecol Res. 2017;43(2):320–9. Furuhashi M, et al. Comparison of complications of vaginal hysterectomy in patients with leiomyomas and in patients with adenomyosis. Arch Gynecol Obstet. 1998;262(1–2):69–73. Berner E, et al. Pelvic pain and patient satisfaction after laparoscopic supracervical hysterectomy: prospective trial. J Minim Invasive Gynecol. 2014;21(3):406–11. Van Praagh I. Conservative surgical treatment for adenomyosis uteri in young women: local excision and metroplasty. Can Med Assoc J. 1965;93(22):1174. Grimbizis GF, Mikos T, Tarlatzis B. Uterus-sparing operative treatment for adenomyosis. Fertil Steril. 2014;101(2):472–487.e8. Chung Y-J, et al. Robot-assisted laparoscopic adenomyomectomy for patients who want to preserve fertility. Yonsei Med J. 2016;57(6):1531–4. Shim JI, et al. A comparison of surgical outcomes between robot and laparoscopy-assisted adenomyomectomy. Medicine. 2019:98(18). Chong GO, et al. Long-term efficacy of laparoscopic or robotic adenomyomectomy with or without medical treatment for severely symptomatic adenomyosis. Gynecol Obstet Investig. 2016;81(4):346–52. Ai-jun S, et al. Characteristics and efficacy of modified adenomyomectomy in the treatment of uterine adenomyoma. Chin Med J. 2011;124(9):1322–6. Takeuchi H, et al. Laparoscopic adenomyomectomy and hysteroplasty: a novel method. J Minim Invasive Gynecol. 2006;13(2):150–4. Fujishita A, et al. Modified reduction surgery for adenomyosis. Gynecol Obstet Investig. 2004;57(3):132–8. Saremi A, et al. Treatment of adenomyomectomy in women with severe uterine adenomyosis using a novel technique. Reprod Biomed Online. 2014;28(6):753–60. Younes G, Tulandi T. Conservative surgery for adenomyosis and results: a systematic review. J Minim Invasive Gynecol. 2018;25(2):265–76. Tan J, et al. Reproductive outcomes after fertility-sparing surgery for focal and diffuse adenomyosis: a systematic review. J Minim Invasive Gynecol. 2018;25(4):608–21. Sizzi O, et al. Italian multicenter study on complications of laparoscopic myomectomy. J Minim Invasive Gynecol. 2007;14(4):453–62. Otsubo Y, et al. Association of uterine wall thickness with pregnancy outcome following uterine-sparing surgery for diffuse uterine adenomyosis. Aust N Z J Obstet Gynaecol. 2016;56(1):88–91. Morimatsu Y, et al. Uterine rupture during pregnancy soon after a laparoscopic adenomyomectomy. Reproductive Med Biol. 2007;6(3):175–7. Kodama K, et al. Fukukukyoka-shikyusenkinsho-tekishutsujutsu go ni shikyuharetsu, yuchakutaiban wo mitome shikyutekishutsu ni itatta ichi-shorei.[a case of hysterectomy due to uterine rupture and placenta accreta after laparoscopic adenomyomectomy.]. J Jpn Soc Endometriosis. 2015;36:189–92. Pollio F, et al. Uterine dehiscence in term pregnant patients with one previous cesarean delivery: growth factor immunoexpression and collagen content in the scarred lower uterine segment. Am J Obstet Gynecol. 2006;194(2):527–34. Chao A-S, et al. Laparoscopic uterine surgery as a risk factor for uterine rupture during pregnancy. PLoS One. 2018;13(5) Parker WH, et al. Risk factors for uterine rupture after laparoscopic myomectomy. J Minim Invasive Gynecol. 2010;17(5):551–4. Kishi Y, Yabuta M, Taniguchi F. Who will benefit from uterus-sparing surgery in adenomyosis-associated subfertility? Fertil Steril. 2014;102(3):802–807.e1. Dueholm M. Uterine adenomyosis and infertility, review of reproductive outcome after in vitro fertilization and surgery. Acta Obstet Gynecol Scand. 2017;96(6):715–26. Author information Authors and Affiliations Editor information Editors and Affiliations Rights and permissions Copyright information © 2021 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. About this chapter Cite this chapter Dai, Y., Leng, J. (2021). The Surgical Treatment of Adenomyosis. In: Xue, M., Leng, J., Wong, F. (eds) Adenomyosis. Springer, Singapore. https://doi.org/10.1007/978-981-33-4095-4_11 Download citation DOI: https://doi.org/10.1007/978-981-33-4095-4_11 Published: Publisher Name: Springer, Singapore Print ISBN: 978-981-33-4094-7 Online ISBN: 978-981-33-4095-4 eBook Packages: MedicineMedicine (R0)

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

adenomyosis

Citation neighborhood

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.

References (48)

Cited by (1)

Source provenance

openalex
last seen: 2026-06-04T00:00:01.174412+00:00
unpaywall
last seen: 2026-06-02T02:00:03.124865+00:00
License: CC0 · commercial use OK