Clinical Investigation on Treatment of Adenomyosis by Combined Video Hysteroscopy and Gestrinone

Objective: To inquire the clinical effect of the treatment on adenomyosis by combined endometrial and partial myometial ablation of video hysteroscopy with Gestrinone. Methods: One hundred and thirty-six cases were divided into two groups randomly. The study group (72 cases) was treated by electrocision in endometrium basal layer and portial myometrium by video hysteroscope, assisted Gestrinone capsules treatment after operation. The control group (64 cases) was treated by Gestrinone capsules only. The follow-up lasted seven to thirty-four months after treatment, including clinical symptoms, uterine volume, serum CA 125 value, relapse rate, and complications. Results: In the follow-up, 66 cases in study group and 59 cases in control group, their menstrual blood volume decreased or stopped. The remission of dysmennorhea was 74.2% in study group and 18.1% in control group, respectively. There was significant difference between two groups in menstrual blood volume and remission of dysmenorrhea (P0.01). The decreased size of uterine volume in study group was higher than that in control group (P0.01). After treatment, mean serum CA 125 value was 21±5.3 U/ml and 48±11.3 U/ml in study group and control group, respectively (P0.01). Relapse rate in study group was lower than control group after six and twelve months' follow-up (P0.01). No operative complication was investigated, but abnormal liver function caused by Gestrinone capsules occurred in two groups. Conclusions: It is a new approach to combined video hysteroscopy assisted Gestrinone capsules for treatment of adenomyosis with significantly clinical effect and low relapse rate.