Conservative adenomyomectomy with transient occlusion of uterine arteries for diffuse uterine adenomyosis

Yong‐Soon Kwon, Yong-Soon Kwon, Hyun Jin Roh, Hyun‐Jin Roh, Jun Woo Ahn, Sang-Hun Lee, Sang‐Hun Lee, Kyong Shil Im
Journal of Obstetrics and Gynaecology Research · 2014 · vol. 41(6) , pp. 938–945 · doi:10.1111/jog.12649 · PMID:25510633 · W2128922469
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This study evaluated adenomyomectomy with transient occlusion of uterine arteries in 26 patients with diffuse uterine adenomyosis, finding it a safe and effective method with high remission rates for pain and bleeding.

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Abstract

AIM: This study aimed to determine the feasibility and safety of adenomyomectomy with transient occlusion of uterine arteries (TOUA) in patients with symptomatic diffuse uterine adenomyosis. MATERIAL AND METHODS: Twenty-six patients with symptomatic diffuse uterine adenomyosis underwent adenomyomectomy with TOUA by a single surgeon at Ulsan University Hospital between May 2011 and September 2012. Surgical outcomes included operative time, intraoperative injury to blood vessels, nerves, and pelvic organs and operative blood loss. We assessed the degree of improvement in dysmenorrhea and menorrhagia at the 4-month follow-up after completion of adjuvant gonadotrophin-releasing hormone agonist. RESULTS: The mean age of patients was 37.73 years (range, 27-49 years). The mean total surgical time was 95.0 min (range, 60-145 min; SD, 34.49). The mean estimated blood loss was 191.54 mL (range, 80-400 mL; SD, 110.91) and there were no cases of injury to the uterine arteries or pelvic nerves. The mean time of TOUA was 9.79 min (range, 6-16 min; SD, 2.74). The mean duration of hospital stay was 5.65 days (range, 4-7 days; SD, 0.85). There were no major complications requiring reoperation or readministration during the mean follow-up period of 13.5 months. At the 7-month follow-up after adenomyomectomy with TOUA, complete remission of dysmenorrhea and menorrhagia was observed in 94.4% and 100% of patients, respectively. CONCLUSIONS: Adenomyomectomy with TOUA could be a safe and effective surgical method in women with symptomatic diffuse uterine adenomyosis to preserve fertility.

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Condition tags

mesh:D004412adenomyosisdysmenorrhea

MeSH descriptors

Adenomyosis Endometrium Myometrium Organ Sparing Treatments Postoperative Complications Therapeutic Occlusion Adenomyosis Adenomyosis Adult Blood Loss, Surgical Blood Loss, Surgical Dysmenorrhea Dysmenorrhea Dysmenorrhea Endometrium Endometrium Feasibility Studies Female Follow-Up Studies Hospitals, University

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References (22)

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