Uterine-sparing surgery for adenomyosis and/or adenomyoma.
Adenomyosis of the uterus is defined as the presence of endometrial tissue, including glands and stroma, situated at least 2.5 mm below the endometrial-myometrial junction and widely distributed within the myometrium layer of the uterus. There is no consensus on the appropriate treatment for symptomatic uterine adenomyosis in women who want to preserve their uterus, partly because adenomyosis is somewhat enigmatic in diagnosis and owing to its clinical significance. Hysterectomy, through either exploratory laparotomy or minimally invasive procedures, is a definite treatment for uterine adenomyosis, once the women have completed childbirth or do not require future fertility. However, many women with a uterine pathology still have a strong desire to preserve the uterus, for which conservative and uterine-sparing procedures are increasingly used, and with which fertility preservation or quality-of-life improvement can be achieved. Although medical management can be effective, similar to the management of uterine fibroids (myoma), its effect is often transient and rapid regrowth of adenomyosis and relapse of symptoms and signs always occur once the treatment is stopped. Therefore, other strategies should be selected. Conservative and uterine-sparing surgery might be one of the most familiar procedures of these uterine-sparing procedures. In this article, the latest knowledge and research evidence on uterine-sparing surgery for uterine adenomyosis are reviewed.
Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Huann-Cheng
HC
Horng
Department of Obstetrics and Gynecology, Taipei Medical University Hospital and Taipei Medical University, Taipei, Taiwan.
Ching-Hui
CH
Chen
Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Chih-Yao
CY
Chen
Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Kuan-Hao
KH
Tsui
Department of Obstetrics and Gynecology, Taipei Medical University Hospital and Taipei Medical University, Taipei, Taiwan. Electronic address: weiminliu50@hotmail.com.
Wei-Min
WM
Liu
Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Immunology Center, Taipei Veterans General Hospital, Taipei, Taiwan; Infection and Immunity Research, National Yang-Ming University, Taipei, Taiwan. Electronic address: phwang@vghtpe.gov.tw.
Peng-Hui
PH
Wang
Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Nursing, National Yang-Ming University School of Nursing, Taipei, Taiwan.
Wen-Hsun
WH
Chang
Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University Hospital, Ilan, Taiwan.
Ben-Shian
BS
Huang
Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Hsu-Dong
HD
Sun
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Ting-Chang
TC
Chang
Department of Obstetrics and Gynecology, China Medical University Hospital and China Medical University, Taichung, Taiwan.
Wei-Chun
WC
Chang
Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Ming-Shyen
MS
Yen
D018194:Adenomyoma / Q000601:surgery*; D062788:Adenomyosis / Q000601:surgery*; D005260:Female; D006801:Humans; D009215:Myometrium / Q000601:surgery*; D059351:Organ Sparing Treatments / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery*
adenomyoma; adenomyosis; uterine-sparing surgery