Can We Replace the Hysterectomy with the Laparoscopic Partial Resection of Adenomyosis for the Relief of Dysmenorrhea and Menorrhagia in Symptomatic Diffuse Adenomyosis?

Abstract

To evaluate the possibility of relief of dysmenorrhea, pelvic pain and menorrhagia after laparoscopic removal of the endometrium and myometrium in the fundus,and both anterior and posterior wall of the upper portion of the adenomyotic uteri.Prospective study from Jan. 2007 to Dec. 2010.EUN's Hosoital,South Korea.288 parous women who suffured from the symptomatic diffuse adenomyosis but wanted to preserve the uterus.All patients were taking 2-100 tablets of analgesics before operation.30% of patients needed to be transfused several pints of blood before operation.After the laparoscopic resection, the normal size of the uterus without focal adenomyosis was observed at vaginal sonogram.The regular asymtomatic menstruations were obseved over 1yr.The endometirum and myometrium of the upper half of the uterus may be considered as the critical region for abnormal ingrowth and invagination of the basal endometrium into the subendometrial myometrial junction causing dysmenorrhea and menorrhagia. To evaluate the possibility of relief of dysmenorrhea, pelvic pain and menorrhagia after laparoscopic removal of the endometrium and myometrium in the fundus,and both anterior and posterior wall of the upper portion of the adenomyotic uteri. Prospective study from Jan. 2007 to Dec. 2010. EUN's Hosoital,South Korea. 288 parous women who suffured from the symptomatic diffuse adenomyosis but wanted to preserve the uterus. All patients were taking 2-100 tablets of analgesics before operation.30% of patients needed to be transfused several pints of blood before operation. After the laparoscopic resection, the normal size of the uterus without focal adenomyosis was observed at vaginal sonogram.The regular asymtomatic menstruations were obseved over 1yr.The endometirum and myometrium of the upper half of the uterus may be considered as the critical region for abnormal ingrowth and invagination of the basal endometrium into the subendometrial myometrial junction causing dysmenorrhea and menorrhagia.