title: Uterus-sparing operative treatment for adenomyosis.
abstract: OBJECTIVE
  To review systematically the literature on uterus-sparing surgical treatment options for adenomyosis.
  
  
  METHODS
  Systematic literature review.
  
  
  METHODS
  Tertiary academic center.
  
  
  METHODS
  Women with histologically proven adenomyosis treated with uterus-sparing surgical techniques.
  
  
  METHODS
  Conservative uterine-sparing surgery for adenomyosis classified as (1) complete excision of adenomyosis, (2) cytoreductive surgery or incomplete removal of the lesion, or (3) nonexcisional techniques, with studies selected if women with adenomyosis were treated surgically without performing hysterectomy.
  
  
  METHODS
  The cure rate after interventional strategies, the rate of symptom (dysmenorrhea and menorrhagia) control, and pregnancy rate in each group of intervention.
  
  
  RESULTS
  A quality assessment tool was used to assess the scientific value of each study. In total, 64 studies dealing with 1,049 patients were identified. After complete excision, the dysmenorrhea reduction, menorrhagia control, and pregnancy rate were 82.0%, 68.8%, and 60.5%, respectively. After partial excision, the dysmenorrhea reduction, menorrhagia control, and pregnancy rate were 81.8%, 50.0%, and 46.9%, respectively.
  
  
  CONCLUSIONS
  Uterine-sparing operative treatment of adenomyosis and its variants appear to be feasible and efficacious. Well-designed, comparative studies are urgently needed to answer the multiple questions arising from this intriguing intervention.
authors.affiliation: 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece. Electronic address: grigoris.grimbizis@gmail.com.
authors.forename: Grigoris F
authors.initials: GF
authors.lastname: Grimbizis
authors.affiliation: 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Themistoklis
authors.initials: T
authors.lastname: Mikos
authors.affiliation: 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Basil
authors.initials: B
authors.lastname: Tarlatzis
mesh_terms: D062788:Adenomyosis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends*; D016896:Treatment Outcome; D014599:Uterus / Q000473:pathology*
keywords: Adenomyoma; adenomyosis; cytoreductive surgery; juvenile cystic adenomyoma; uterus-sparing surgery