title: Comparison of surgery alone and combined surgical-medical treatment in the management of symptomatic uterine adenomyoma.
abstract: OBJECTIVE
  To compare the efficacy of surgical-medical treatment and surgery alone in the treatment of uterine symptomatic adenomyoma.
  
  
  METHODS
  Prospective nonrandomized study.
  
  
  METHODS
  Medical centers.
  
  
  METHODS
  One hundred sixty-five women treated with conservative adenomyomectomy.
  
  
  METHODS
  Surgery followed by six-course treatment (n = 114, surgical-medical group) or no treatment (n = 51, surgery-alone group) with a gonadotropin-releasing hormone (GnRH) agonist regimen.
  
  
  METHODS
  Symptom relief (scale: 0, no symptoms, to 5, worst symptoms) and relapse (when any one scale was > or =2 after treatment) during the 2-year follow-up period.
  
  
  RESULTS
  The general characteristics of the patients were similar in both groups, except for the diameter of the adenomyoma and age. Patients in both groups had statistically significant symptom relief, and all symptom scores declined from a mean of 3 or 4 to a mean of 1 or less at the end of the 2-year follow-up period. The symptom-relapse rates in the surgical-medical group were statistically significantly lower than those in the surgery alone group (n = 32, 28.1% vs. n = 25, 49.0%, respectively).
  
  
  CONCLUSIONS
  Conservative surgery, regardless of GnRH agonist treatment, may be acceptable for management of a selected population with severe symptomatic adenomyoma. However, surgical-medical treatment provided more effective symptom control (a lower symptom relapse rate) than surgery alone during the 2-year follow-up period.
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan. Electronic address: phwang@vghtpe.gov.tw.
authors.forename: Peng-Hui
authors.initials: PH
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Medical University Hospital and Taipei Medical University, Taipei, Taiwan.
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Liu
authors.affiliation: Neurological Institute, Taipei Veterans General Hospital and National Yang-Ming University Schools of Medicine, Taipei, Taiwan.
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Ming-Huei
authors.initials: MH
authors.lastname: Cheng
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Hsiang-Tai
authors.initials: HT
authors.lastname: Chao
mesh_terms: D018194:Adenomyoma / Q000188:drug therapy* / Q000601:surgery*; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000601:surgery*
chemical_list: D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide