Long-Term Efficacy of Laparoscopic or Robotic Adenomyomectomy with or without Medical Treatment for Severely Symptomatic Adenomyosis

Gun Oh Chong, Chong GO, Lee YH, Yoon Hee Lee, Hong DG, Dae Gy Hong, Cho YL, Young Lae Cho, Lee YS, Yoon Soon Lee
Gynecologic and obstetric investigation · 2016 · vol. 81(4) , pp. 346–352 · doi:10.1159/000441783 · PMID:26894488 · W2276861700
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Laparoscopic or robotic adenomyomectomy with uterine artery ligation provided long-term symptom relief for severe adenomyosis, with no significant difference in outcomes between surgical-only and surgical-medical treatment groups.

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Abstract

BACKGROUND/AIMS: To determine the long-term efficacy of laparoscopic or robotic adenomyomectomy with or without gonadotropin-releasing hormone (GnRH) for the treatment of severely symptomatic adenomyosis. METHODS: Between August 2008 and May 2011, we prospectively observed 33 patients who underwent laparoscopic or robotic adenomyomectomy with uterine artery ligation for the treatment of symptomatic adenomyosis. Seventeen patients (52%) received 3-course GnRH agonist treatment after the adenomyomectomy. RESULTS: The mean operating time was 147.4 ± 52.0 min, and the mean blood loss was 36.1 ± 37.4 ml. Postoperative complications occurred in 5 patients, including 4 cases of febrile morbidity, 1 case of ileus and 1 case of pelvic abscess. Patients had statistically significant symptom relief during the 3-year follow-up period. Four of the 33 patients (12%) showed symptom relapse; 3 patients showed a relapse with dysmenorrhea and 1 patient showed a relapse with menorrhagia. There were no significant differences in terms of therapeutic outcomes between surgical-only and surgical-medical treatment. CONCLUSION: Laparoscopic or robotic adenomyomectomy was feasible and safe for women with severely symptomatic adenomyosis who requested uterine preservation. Moreover, this procedure provided long-term symptom control, regardless of postoperative GnRH agonist administration.

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Condition tags

dysmenorrheaadenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Gynecologic Surgical Procedures Laparoscopy Laparoscopy Robotics Robotics Adenomyosis Adenomyosis Adult Adult Dysmenorrhea Dysmenorrhea Dysmenorrhea Female Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Gynecologic Surgical Procedures

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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