[Clinical observation of conservative surgery for adenomyosis].

OBJECTIVE: To study the clinical value of conservative surgery for adenomyosis in reducing symptoms and raising pregnancy rate. METHODS: 26 women with histologically proven adenomyosis who wanted to preserve their reproductive capacity had conservative surgery (adenomyomectomy or remove part lesion). The patient's average age was 35.8 years. The main complaints were dysmenorrhea and hypermenorrhea. Of the 22 married patients, 7 had primary infertility (31.8%), 10 had secondary infertility (45.5%) and 3 had habitual abortion (13.6%). RESULTS: 10 patients had adenomyoma, the lesion were completely removed. Sixteen patients had adenomyosis, the part of lesion were removed. The rate of the severe dysmenorrhea and hypermenorrhea after operation were significantly lower than that before (P < 0.001). After operation, 7 patients with adenomyoma wanted to have a baby, 5 patients conceived, of the total 9 pregnancies, 5 ended in term pregnancy; 14 patients with diffuse adenomyosis wanted to have a baby, 3 patients had 3 pregnancies. One of which ended in term pregnancy. The rate of pregnancy and term delivery in adenomyoma patients were significantly higher than that of adenomyosis patients (P = 0.03, P = 0.002). Among 26 patients, 3 relapsed. The average relapse time was 49.6 months. CONCLUSIONS: The conservative surgery for adenomyoma can reduce symptom and raise pregnancy rate significantly, it can be accepted by young women who want to preserve their reproductive capacity. Though the pregnancy rate of conservative surgery for diffused adenomyosis was low, it still has therapeutic value.