Laparoscopic bipolar coagulation for the conservative treatment of adenomyomata.
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.
Phillips
D R
DR
Department of Obstetrics and Gynecology, South Nassau Communities Hospital, Oceanside, New York, USA.
Nathanson
H G
HG
Milim
S J
SJ
Haselkorn
J S
JS
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*
D018931:Antineoplastic Agents, Hormonal; D016729:Leuprolide