Current Treatment for Adenomyosis

In: Uterine Adenomyosis · 2015 · pp. 169–182 · doi:10.1007/978-3-319-13012-5_12 · W2283980646
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Modern imaging allows for less radical adenomyosis treatment options like hormonal therapies or uterine-sparing surgeries, though evidence for efficacy and pregnancy outcomes remains limited.

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This paper reviews current treatment approaches for adenomyosis, discussing how advances in MRI and modern ultrasound enabled diagnosis beyond hysterectomy specimens and expanded options for less radical care. It summarizes symptomatic management for heavy bleeding and dysmenorrhea and outlines multiple hormonal therapies (including GnRH agonists, levonorgestrel-releasing intrauterine device, continuous oral contraceptives, progestogens, danazol, and aromatase inhibitors), noting that the evidence base for these options is limited and that recurrence often occurs after discontinuation. The review also describes uterus-sparing procedures such as adenomyomectomy, hysteroscopic endomyometrial ablation, and uterine artery embolisation, while emphasizing limitations related to adenomyosis being often diffuse and uncertainty about effects on future pregnancy. This paper is centrally about adenomyosis — it is a narrative overview of current medical and surgical treatments and their evidence limitations and recurrence/pregnancy uncertainties.

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Abstract

Prior to the identification of diagnostic criteria for adenomyosis using modern imaging, the condition could only be diagnosed in hysterectomy specimens. The use of Magnetic Resonance Imaging and modern Ultrasound created the conditions for less radical treatment. This may include symptomatic treatment for heavy bleeding or dysmenorrhea, gonadotropin-releasing hormone agonists, levonorgestrel-releasing intrauterine device, continuous administration of the oral contraceptive pill, progestogens, danazol or aromatase inhibitors but the evidence base for these options is limited and the disease recurs following discontinuation. Uterine sparing adenomyomectomy, hysteroscopic endomyometrial ablation or uterine artery embolisation may have a role. But these options remain limited because of the often diffuse nature of adenomyosis and because of uncertainty about the effect on future pregnancy Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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Uterine artery embolisation for symptomatic adenomyosis with polyzene F-coated hydrogel microspheres: three-year clinical follow-up using UFS-QoL questionnaire. Cardiovasc Intervent Radiol. 2014;2. Torre A, Paillusson B, Fain V, Labauge P, Pelage JP, Fauconnier A. Uterine artery embolization for severe symptomatic fibroids: effects on fertility and symptoms. Hum Reprod. 2014;29:490–501. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2016 Springer International Publishing Switzerland About this chapter Cite this chapter Berlanda, N., Buggio, L., Vercellini, P. (2016). Current Treatment for Adenomyosis. In: Habiba, M., Benagiano, G. (eds) Uterine Adenomyosis. Springer, Cham. https://doi.org/10.1007/978-3-319-13012-5_12 Download citation DOI: https://doi.org/10.1007/978-3-319-13012-5_12 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-13011-8 Online ISBN: 978-3-319-13012-5 eBook Packages: MedicineMedicine (R0)

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