title: Laparoscopic bipolar coagulation for the conservative treatment of adenomyomata.
abstract: OBJECTIVE
  To assess the effectiveness of treating adenomyomata with laparoscopic bipolar coagulation.
  
  
  METHODS
  Prospective, observational study. Setting. The gynecology department of a community hospital.
  
  
  METHODS
  Ten women, each with severe dysmenorrhea, chronic menorrhagia, and adenomyomata diagnosed by magnetic resonance imaging.
  
  
  METHODS
  Laparoscopic bipolar coagulation of adenomyomata.
  
  
  RESULTS
  The mean (+/- SEM) total adenomyoma volume before leuprolide acetate administration was 119 +/- 16 cm3 (range 6-190 cm3); after 3 months of therapy this was reduced to 86 +/- 8 cm3 (range 6-162 cm3, p <0. 0001) a 27.7% reduction. Further reduction occurred 7 to 12 months postoperatively to 31 +/- 3.4 cm3 (range 3-155 cm3, p <0.0001), a 73.9% reduction from baseline. Twelve months postoperatively, seven (70.0%, p <0.05) women had continued resolution or significant reduction of dysmenorrhea and resolution of menorrhagia. One woman (10.0%) with unresolved dysmenorrhea and menorrhagia required hysterectomy, and two (20.0%) with recurrent menorrhagia required resection of the endomyometrium; one continued to have menorrhagia but refused further surgical or medical treatment.
  
  
  CONCLUSIONS
  Conservative treatment obviated the need for major surgery in 90% of women with adenomyomata, but further evaluation of this technique is necessary to determine its definitive role.
authors.affiliation: Department of Obstetrics and Gynecology, South Nassau Communities Hospital, Oceanside, New York, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: Phillips
authors.forename: H G
authors.initials: HG
authors.lastname: Nathanson
authors.forename: S J
authors.initials: SJ
authors.lastname: Milim
authors.forename: J S
authors.initials: JS
authors.lastname: Haselkorn
mesh_terms: D018194:Adenomyoma / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D004412:Dysmenorrhea / Q000209:etiology; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D010535:Laparoscopy; D016729:Leuprolide / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008595:Menorrhagia / Q000209:etiology; D008875:Middle Aged; D012008:Recurrence; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D016729:Leuprolide