Current and Future Surgical and Interventional Management Options for Adenomyosis

Joseph Chen, Anne E Porter, Kimberly A Kho
Seminars in reproductive medicine · 2020 · vol. 38(02/03) , pp. 157–167 · doi:10.1055/s-0040-1718921 · PMID:33152768 · W3095174630
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper reviews current and future uterine-sparing surgical and interventional options for adenomyosis, noting symptom improvement but the need for long-term fertility and obstetric outcome data.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This narrative review examines current and emerging surgical and interventional management strategies for adenomyosis, contrasting the historical role of hysterectomy with uterine-sparing options such as adenomyomectomy and wedge resection, uterine artery embolization, radiofrequency thermal ablation, hysteroscopic excision, endometrial ablation, and high-intensity focused ultrasound. Across largely investigative evidence, the review reports improvements in symptoms including abnormal uterine bleeding, dysmenorrhea, pelvic pain, and overall quality of life. The paper explicitly emphasizes that longer-term outcome data—particularly regarding fertility and obstetric outcomes—remain needed for many uterine-preserving techniques. Relevance to endometriosis: the paper is centrally about adenomyosis management rather than endometriosis, and it does not explicitly discuss endometriosis within the provided text, but it was included in the corpus via upstream keyword match for pelvic endometrial conditions.

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Abstract

Historically, hysterectomy has been the recommended treatment for patients with adenomyosis. However, in the past two decades, various uterine-sparing treatment methods have emerged. These range from excisional techniques such as adenomyomectomy or wedge resection to uterine artery embolization, radiofrequency thermal ablation, hysteroscopic excision, endometrial ablation, and high-intensity focused ultrasound. While largely investigative for the treatment of adenomyosis, these procedures have demonstrated improvement in symptoms including abnormal uterine bleeding, dysmenorrhea, pelvic pain, and overall quality of life. However, long-term data including fertility and obstetric outcomes are needed. Future research is needed to better understand the impact of these uterine-preserving techniques to expand our armamentarium for the treatment of adenomyosis.

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Condition tags

dysmenorrheaadenomyosis

MeSH descriptors

Adenomyosis Fertility Preservation Adenomyosis Dysmenorrhea Dysmenorrhea Extracorporeal Shockwave Therapy Extracorporeal Shockwave Therapy Female Fertility Preservation Humans Hysterectomy Hysterectomy Menorrhagia Menorrhagia Uterine Artery Embolization Uterine Artery Embolization Uterus Uterus

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (65)

Cited by (17)

Source provenance

europepmc
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License: CC0 · commercial use OK