title: Long-term follow-up of severely symptomatic women with adenomyoma treated with combination therapy.
abstract: OBJECTIVE
  The aim of our study was to assess the long-term efficacy of conservative surgery combined with gonadotropin-releasing hormone agonist therapy for uterine adenomyoma.
  
  
  METHODS
  We carried out an uncontrolled descriptive study of 285 women who had symptomatic uterine adenomyoma. A total of 186 women with pathologically proven adenomyoma underwent ultramini-laparoscopic adenomyomectomy and a 6-month course of goserelin acetate treatment, and were evaluated semi-annually during a follow-up period of at least 3 years.
  
  
  RESULTS
  Patient scores for dysmenorrhea using a self-reported six-point verbal numeric rating scale significantly declined compared with the baseline assessment, from 3.84 ± 0.65 to 0.33 ± 0.57, 0.52 ± 0.86, and 0.88 ± 1.29 at the end of the 1-, 2-, and 3-year follow-up visits, respectively (p < 0.001). Similar reductions were observed for analgesic usage scores. Menorrhagia scores significantly decreased compared with the baseline assessment, from 3.45 ± 1.46 to 0.42 ± 0.59, 0.65 ± 0.83, and 1.1 ± 1.34 at the end of the 1-, 2-, and 3-year follow-up visits, respectively (p < 0.001).
  
  
  CONCLUSIONS
  Combination therapy for adenomyoma provides an effective treatment option for long-term symptom control and uterine preservation in severely symptomatic women for whom previous long-term drug therapy has failed or proven to be intolerable.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. weiminliu50@hotmail.com
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Liu
authors.forename: Ching-Hui
authors.initials: CH
authors.lastname: Chen
authors.forename: Li-Hsuan
authors.initials: LH
authors.lastname: Chiu
authors.forename: Chii-Ruey
authors.initials: CR
authors.lastname: Tzeng
mesh_terms: D018194:Adenomyoma / Q000150:complications / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D004412:Dysmenorrhea / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D008595:Menorrhagia / Q000209:etiology; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000150:complications / Q000628:therapy*; D014599:Uterus / Q000601:surgery*; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D017273:Goserelin