Diffüz ve Fokal Adenomyosisin Cerrahi Yönetimi

Ahmet Kale, Fatma Nur Tüysüzoğlu
In: Tüp Bebek Okulu Klinik ve Embriyoloji Eğitim Kitabı · 2026 · pp. 325–330 · doi:10.37609/akya.3886.c5063 · W7164049352
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⚙ AI-generated summary by gemini-2.5-flash-lite+body, 2026-07-09 ⓘ

This review discusses the surgical management of diffuse and focal adenomyosis, referencing various conservative and minimally invasive techniques.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

The paper focuses on surgical management approaches for diffuse and focal uterine adenomyosis, drawing on a range of techniques reported in the literature, including conservative uterus-sparing operations (e.g., adenomyomectomy and wedge-shaped or reduction-type resections) and various image- or ultrasound-guided ablation approaches. Across the cited works, key reported themes are the feasibility of fertility-preserving or uterus-conserving surgery and the clinical discussion of outcomes, such as reproductive endpoints and symptom-related effects, as well as technical considerations for procedure performance. A major limitation is that the text is a narrative synthesis centered on heterogeneous prior studies, with variable patient selection and differing outcome reporting across techniques rather than presenting a single unified prospective dataset. Relevance to endometriosis: adenomyosis is discussed as a distinct uterine pathology within a broader gynecologic surgical and reproductive context, though the paper does not explicitly focus on endometriosis; it is included in the corpus because the upstream search index matched adenomyosis-related surgical management terms.

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Diffüz ve Fokal Adenomyosisin Cerrahi Yönetimi Özet Referanslar Leyendecker G, Kunz G, Kissler S, et al. Adenomyosis and reproduction. Best Practice Research Clinical Obstetrics Gynaecology. 2006;20(4):523–546. Hyams L. Adenomyosis; its conservative surgical treatment (hysteroplasty) in young women. New York State Journal of Medicine. 1952;52(22):2778–2784. Bergeron C, Amant F,Ferenczy A.Pathology and physiopathology of adenomyosis. Best Practice Research Clinical Obstetrics Gynaecology. 2006;20(4):511–521. Gilks C, Clement P, Hart W, et al. Uterine adenomyomas excluding atypical polypoid adenomyomas and adenomyomas of endocervical type: a clinicopathologic study of 30 cases of an underemphasized lesion that may cause diagnostic problems with brief consideration of adenomyomas of other female genital tract sites. International Journal of Gynecological Pathology. 2000;19(3):195–205. Grimbizis G, Mikos T, Zepiridis L, et al. Laparoscopic excision of uterine adenomyomas. Fertil Steril. 2008;89(4):953–961. Wang J,Wu R,Xu K,et al.Single large cystic adenomyoma of the uterus after cornual pregnancy and curettage. Fertil Steril. 2007;88(4):965–967. Mazur M.Atypical polypoid adenomyomas of the endometrium.The American Journal of Surgical Pathology. 1981;5(5):473–482. Osada H, Silber S, Kakinuma T, et al.Surgical procedure to conserve the uterus for future pregnancy in patients suffering from massive adenomyosis. Reproductive Biomedicine Online.2011;22(1):94–99. Takeuchi H, Kitade M, Kikuchi I, et al. Diagnosis, laparoscopic management, and histopathologic findings of juvenile cystic adenomyoma: a review of nine cases. Fertil Steril 2010;94(3):862–868. Protopapas A, Millingos S, Markaki S, et al. Cystic uterine tumors. Gynecologic and Obstetric Investigation. 2008;65(4):275–280. Nishida M, Takano K, Arai Y, et al. Conservative surgical management for diffuse uterine adenomyosis. Fertil Steril 2010;94(2):715–719. Wood C.Surgical and medical treatment of adenomyosis. Human Reproduction Update.1998;4(4):323–336. Shu S, Luo X,Wang Z,et al. Fifteen cases clinical analysis of wedge-shaped resection of uterus treating adenomyosis. Medicine 2016;95(24):3805. Saremi A, Bahrami H, Salehian P, et al.Treatment of adenomyomectomy in women with severe uterine adenomyosis using a novel technique. Reproductive biomedicine online. 2014;28(6), 753-760. Fujishita A, Masuzaki H, Khan K, et al. Modified reduction surgery for adenomyosis: a preliminary report of the transverse H incision technique. Gynecologic and obstetric investigation. 2004; 57(3):132-138. Yoon S, Lee G, Cho, H, et al. Clinical efficacy of a novel method of fertility-preserving adenomyomectomy in infertile women with diffuse adenomyosis. Medicine (Baltimore). 2023;102(13), e33266 Kim J, Shin C, Ko Y, et al. Laparoscopic assisted adenomyomectomy using double flap method. Obstetrics & gynecology science. 2014;57(2):128-135. Hijazi A, Chung Y, Sinan N, et al. A novel technique for myometrial defect closure after robot-assisted laparoscopic adenomyomectomy: A retrospective cohort study. Taiwanese Journal of Obstetrics and Gynecology. 2022;61(1):75-79. Fan T, Zhang L, Chen W, et al. Feasibility of MRI-guided high intensity focused ultrasound treatment for adenomyosis. European Journal of Radiology. 2012; 81(11):3624–3630. Zhang L, Rao F, Setzen R. High intensity focused ultrasound for the treatment of adenomyosis: Selection criteria, efficacy, safety and fertility. Acta Obstetricia et Gynecologica Scandinavica. 2017; 96:707–714. Huang Y, Deng J, Wei X, et al. A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with high-intensity focused ultrasound and laparoscopic excision. International Journal of Hyperthermia. 2020;37(1):301–307. Lee J, Hong G, Lee K, et al. Changes in anti-Müllerian hormone levels as a biomarker for ovarian reserve after ultrasound-guided high-intensity focused ultrasound treatment of adenomyosis and uterine fibroid. BJOG: An international journal of Obstetrics and Gynaecology. 2017;124(3):18–22. Liu X, Wang W, Wang Y, et al. Clinical predictors of long-term success in ultrasound-guided high-intensity focused ultrasound ablation treatment for adenomyosis: A retrospective study. Medicine(Baltimore). 2016;95(3):e2443. Lin X, Hai N, Zhang J, et al. Comparison between microwave ablation and radiofrequency ablation for treating symptomatic uterine adenomyosis. International Journal of Hyperthermia. 2020;37(1):151–156. Hai N, Hou Q, Ding X, et al. Ultrasound-guided transcervical radiofrequency ablation for symptomatic uterine adenomyosis. The British Journal of Radiology. 2017; 90(1069):20160119. Zhang S, Wang K, Di A, et al. Ultrasound-guided percutaneous microwave ablation of adenomyosis: A narrative review. Annals of Palliative Medicine. 2021;10(11):12003–12011

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