Conservative surgical management for uterine adenomyasis

Adenomyosis,usually in women in their late fourth and fifth decades. It causes severe dysmenorrhea,chronic pelvic pain,increased menstrual volume,and infertility,which all seriously interfere with patients’ quality of life. For decades,hysterectomy was the only therapeutic option available to women with adenomyosis. The last two decades witness a considerable accumulation of information on therapeutic options other than hysterectomy for adenomyosis. Conservative surgeries include myometrial excision,endometrial ablation/resection via hysteroscopy,uterine artery ligation,laparoscopic uterosacral nerve ablation and presacral neurectomy,are at the surgeon's disposal. Patient's age and symptoms,desired fertility,site and extent of lesion and surgeon’s skills should be considered in choosing the appropriate procedure. Various therapeutic options for adenomyosis,combination of procedures becomes available in the last decades and need evaluation and improvement.