2848 Treatment of Adenomyosis by Hysteroscope

Abstract

Video Objective To demonstrate a novel hysteroscopic surgery for adenomyosis. Setting The benign gynecology department at a university hospital. Interventions We performed a hysteroscopic minimally operation to treat symptomatic myometrial adenomyosis. The operations were performed under transabdominal ultrasound-guide. We used a cutting loop to resect the lesions repeatedly and progressively with the standard electroresection. The operation was considered complete when the pink fasciculate structure of the myometrium appeared. This study was approved by the institutional ethics committee of the International Peace Maternity and Child Health Hospital in Shanghai, China, on 19 April 2016. The approval number is GLW (2015) 19.Following-up were performed for 2 times at 3-months interval. The patient menstruated regularly. The postoperative VAS scores of dysmenorrhea and menstrual blood volume declined significantly after operation. 6 months after the operation the uterine volume evaluated by magnetic resonance imaging (MRI) reduced by about 33%. Conclusion Traditionally, adenomyosis is often an incidental finding in specimens obtained from hysterectomy or uterine biopsies and/or percutaneous ultrasound-based biopsies. The modern diagnostic imaging techniques, such as (MRI), contributing to improving accuracy in the identification of this pathology, results in that the conservative uterine-sparing treatments of adenomyosis appear to be feasible and efficacious. Hysteroscopic excision of uterine adenomyosis has the following benefits: the uterine is reserved and the symptoms of adenomyosis get improvement; the minimally invasive operation is short-time taking and the patients recovers quickly. Therefore, hysteroscopic excision provides an effective and optional conservative technique for the treatment of adenomyosis.