New interventional techniques for adenomyosis

Jaron Rabinovici, Rabinovici J, Elizabeth A. Stewart
Best practice & research. Clinical obstetrics & gynaecology · 2006 · vol. 20(4) , pp. 617–636 · doi:10.1016/j.bpobgyn.2006.02.002 · PMID:16934530 · W2123795182
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This paper explores novel interventional techniques developed for the treatment of adenomyosis.

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Abstract

This chapter demonstrates that new interventional techniques have been introduced over recent years in order to find an adequate non-invasive therapy for adenomyosis. There is no evidence-based medicine to guide us in the treatment of adenomyosis with minimally invasive therapy. In fact, most data regarding adenomyosis and these evolving therapies comes from the inadvertent treatment of adenomyosis in studies designed to treat uterine leiomyomas. Essentially, all data are from case reports or small case series. The problem is compounded by the fact that there is no agreed imaging definition of adenomyosis, and so therapies that do not excise the uterus have no 'gold standard' for comparison. Nonetheless, there are some reports suggesting that there may be efficacy in techniques such as medicated intrauterine devices, uterine artery embolization, and MRI-guided focused ultrasound surgery. Larger studies specifically treating adenomyosis are clearly required. As with every new approach, the widespread success of these techniques will depend on the general adoption of adequate diagnostic solutions and improvements in the technical parameters of these new regimens. Since the techniques presented in this chapter are new, they have not yet undergone the necessary thorough scientific scrutiny and discussion that is needed for their general acceptance. In the past, adenomyosis was mainly a 'post-factum' pathological diagnosis after extensive surgery. Based on the evidence presented in this chapter it seems that adenomyosis has become an entity that might be treatable by new, minimally invasive or non-invasive treatments.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Endometriosis Uterine Diseases Adult Contraceptives, Oral, Synthetic Contraceptives, Oral, Synthetic Danazol Danazol Diagnosis, Differential Embolization, Therapeutic Embolization, Therapeutic Endometriosis Endometriosis Estrogen Antagonists Estrogen Antagonists Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gynecologic Surgical Procedures Gynecologic Surgical Procedures

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