The experience of organ-preserving surgical treatment of patients with severe forms of adenomyosis

The paper reports an institutional experience (2012–2016) with organ-preserving adenomyomectomy using H. Osada’s method in 18 reproductive-age women with severe adenomyosis, characterized clinically by chronic abnormal uterine bleeding and often dysmenorrhea, dyspareunia, anemia, and prior unsuccessful hormonal therapy. All operations were performed via laparotomy with uterine wall reconstruction, with no intra- or postoperative complications reported; histology showed widespread intramyometrial glandular–stromal endometriosis, and one-third had combined adenomyosis and myometrial myoma features. At follow-up (2–42 months), menstrual function normalized in all women (100%), no recurrence of pathological symptoms was registered, and two spontaneous pregnancies resulted in live full-term births via cesarean delivery, while others were on postoperative hormonal therapy or planned assisted reproduction. The study’s main limitation is its small, uncontrolled case series design with a short and variable follow-up period. This paper is centrally about endometriosis and adenomyosis research—specifically severe adenomyosis treated with organ-preserving adenomyomectomy (and histologically demonstrating intramyometrial endometriosis within adenomyosis tissue).

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