Surgery in adenomyosis

Introduction Adenomyosis is defined as the presence of endometrial glands and stroma within the myometrium. The true prevalence is unknown and has been reported to range from 1 to 70%. It has a significantly negative impact on women’s quality of life, causing abnormal uterine bleeding, dysmenorrhea, and chronic pelvic pain. The definitive treatment for adenomyosis is hysterectomy, although it does not contemplate patients who wish to preserve their fertility. The aim of this paper is to discuss the latest evidence on the surgical techniques for the treatment of adenomyosis published in medical–scientific databases.

A comprehensive literature search for articles published from 1996 to 2017 related to surgery for adenomyosis was made in Pubmed, Medline, the Cochrane Library, and Google Scholar, in English, by the following MeSH terms: adenomyosis, surgery, pathogenesis, dysmenorrhea and infertility.

There is extensive evidence on several surgical approaches for the improvement of adenomyosis-related symptoms; however, there is no robust evidence that they are effective for infertility.

The management of adenomyosis is quite complex and controversial. Complications after extensive uterine reconstruction, such as uterine rupture, should be considered and discussed with the patient. There are still limited data to support surgery effectiveness, especially for infertility, and further well-designed studies are required. Similar content being viewed by others

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Funding No external funding was involved during this analysis. Ethical statement This article does not contain any studies with human participants or animals performed by any of the authors. Rights and permissions About this article Cite this article Oliveira, M.A.P., Crispi, C.P., Brollo, L.C. et al. Surgery in adenomyosis. Arch Gynecol Obstet 297, 581–589 (2018). https://doi.org/10.1007/s00404-017-4603-6 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-017-4603-6