Conservative Surgery in the Management of Adenomyosis

Masato Nishida; Hiroya Itagaki; Yasuo Otsubo; Yuko Arai

doi:doi:10.11648/j.jgo.20190701.12

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Conservative Surgery in the Management of Adenomyosis

Masato Nishida, Hiroya Itagaki, Yasuo Otsubo, Yuko Arai

Published in Journal of Gynecology and Obstetrics (Volume 7, Issue 1)

Received: 29 December 2018 Accepted: 11 February 2019 Published: 28 February 2019

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Abstract

Since 2002, we have performed adenomyomectomy for 1780 women with uterine adenomyosis. We classified adenomyosis in these patients as focal (n=1313), diffuse (n=450) or cystic (n=17) type according to the distribution of the focuses seen in magnetic resonance imaging (MRI) findings. Three different surgical methods for focal, diffuse and cystic adenomyosis are utilized at our institution. The adenomyosis lesion is excised using a loop electrode of a high-frequency cutter in all methods. The median resected lesion weight of focal, diffuse and cystic adenomyosis were 94 g (1-1156 g), 150 g (10-1595 g), and 16 g (3-45 g), respectively. The mean visual analogue score for dysmenorrhea decreased from 9.1 to 1.0 and heavy menstrual bleeding was improved in all cases. Following the procedure, 370 pregnancies occurred in 294 patients, of which 153 (41.9%) were the result of natural conception. Pregnancy rate of the patients younger than 40 years were 35.1% in focal type, 25.4% in diffuse type and 88.9% in cystic type. Among those patients, we experienced 5 cases of uterine rupture. Of 1462 patients who underwent surgery more than 2 years prior to the time of writing, recurrence occurred in 150 (10.3%). Our findings indicate that conservative surgery for uterine adenomyosis using a high-frequency resection device is effective for both focal and diffuse type.

Published in	Journal of Gynecology and Obstetrics (Volume 7, Issue 1)
DOI	10.11648/j.jgo.20190701.12
Page(s)	8-16
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Adenomyosis, Conservative Surgery, Classification, Prognosis, Pregnancy, Recurrence

References

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APA Style

Masato Nishida, Hiroya Itagaki, Yasuo Otsubo, Yuko Arai. (2019). Conservative Surgery in the Management of Adenomyosis. Journal of Gynecology and Obstetrics, 7(1), 8-16. https://doi.org/10.11648/j.jgo.20190701.12

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ACS Style

Masato Nishida; Hiroya Itagaki; Yasuo Otsubo; Yuko Arai. Conservative Surgery in the Management of Adenomyosis. J. Gynecol. Obstet. 2019, 7(1), 8-16. doi: 10.11648/j.jgo.20190701.12

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AMA Style

Masato Nishida, Hiroya Itagaki, Yasuo Otsubo, Yuko Arai. Conservative Surgery in the Management of Adenomyosis. J Gynecol Obstet. 2019;7(1):8-16. doi: 10.11648/j.jgo.20190701.12

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@article{10.11648/j.jgo.20190701.12,
  author = {Masato Nishida and Hiroya Itagaki and Yasuo Otsubo and Yuko Arai},
  title = {Conservative Surgery in the Management of Adenomyosis},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {7},
  number = {1},
  pages = {8-16},
  doi = {10.11648/j.jgo.20190701.12},
  url = {https://doi.org/10.11648/j.jgo.20190701.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20190701.12},
  abstract = {Since 2002, we have performed adenomyomectomy for 1780 women with uterine adenomyosis. We classified adenomyosis in these patients as focal (n=1313), diffuse (n=450) or cystic (n=17) type according to the distribution of the focuses seen in magnetic resonance imaging  (MRI) findings. Three different surgical methods for focal, diffuse and cystic adenomyosis are utilized at our institution. The adenomyosis lesion is excised using a loop electrode of a high-frequency cutter in all methods. The median resected lesion weight of focal, diffuse and cystic adenomyosis were 94 g (1-1156 g), 150 g (10-1595 g), and 16 g (3-45 g), respectively. The mean visual analogue score for dysmenorrhea decreased from 9.1 to 1.0 and heavy menstrual bleeding was improved in all cases. Following the procedure, 370 pregnancies occurred in 294 patients, of which 153 (41.9%) were the result of natural conception. Pregnancy rate of the patients younger than 40 years were 35.1% in focal type, 25.4% in diffuse type and 88.9% in cystic type. Among those patients, we experienced 5 cases of uterine rupture. Of 1462 patients who underwent surgery more than 2 years prior to the time of writing, recurrence occurred in 150 (10.3%). Our findings indicate that conservative surgery for uterine adenomyosis using a high-frequency resection device is effective for both focal and diffuse type.},
 year = {2019}
}

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TY - JOUR
T1 - Conservative Surgery in the Management of Adenomyosis
AU - Masato Nishida
AU - Hiroya Itagaki
AU - Yasuo Otsubo
AU - Yuko Arai
Y1 - 2019/02/28
PY - 2019
N1 - https://doi.org/10.11648/j.jgo.20190701.12
DO - 10.11648/j.jgo.20190701.12
T2 - Journal of Gynecology and Obstetrics
JF - Journal of Gynecology and Obstetrics
JO - Journal of Gynecology and Obstetrics
SP - 8
EP - 16
PB - Science Publishing Group
SN - 2376-7820
UR - https://doi.org/10.11648/j.jgo.20190701.12
AB - Since 2002, we have performed adenomyomectomy for 1780 women with uterine adenomyosis. We classified adenomyosis in these patients as focal (n=1313), diffuse (n=450) or cystic (n=17) type according to the distribution of the focuses seen in magnetic resonance imaging (MRI) findings. Three different surgical methods for focal, diffuse and cystic adenomyosis are utilized at our institution. The adenomyosis lesion is excised using a loop electrode of a high-frequency cutter in all methods. The median resected lesion weight of focal, diffuse and cystic adenomyosis were 94 g (1-1156 g), 150 g (10-1595 g), and 16 g (3-45 g), respectively. The mean visual analogue score for dysmenorrhea decreased from 9.1 to 1.0 and heavy menstrual bleeding was improved in all cases. Following the procedure, 370 pregnancies occurred in 294 patients, of which 153 (41.9%) were the result of natural conception. Pregnancy rate of the patients younger than 40 years were 35.1% in focal type, 25.4% in diffuse type and 88.9% in cystic type. Among those patients, we experienced 5 cases of uterine rupture. Of 1462 patients who underwent surgery more than 2 years prior to the time of writing, recurrence occurred in 150 (10.3%). Our findings indicate that conservative surgery for uterine adenomyosis using a high-frequency resection device is effective for both focal and diffuse type.
VL - 7
IS - 1
ER -

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Author Information

Masato Nishida

Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Japan
Hiroya Itagaki

Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Japan
Yasuo Otsubo

Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Japan
Yuko Arai

Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Tsuchiura, Japan

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APA Style

Masato Nishida, Hiroya Itagaki, Yasuo Otsubo, Yuko Arai. (2019). Conservative Surgery in the Management of Adenomyosis. Journal of Gynecology and Obstetrics, 7(1), 8-16. https://doi.org/10.11648/j.jgo.20190701.12

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ACS Style

Masato Nishida; Hiroya Itagaki; Yasuo Otsubo; Yuko Arai. Conservative Surgery in the Management of Adenomyosis. J. Gynecol. Obstet. 2019, 7(1), 8-16. doi: 10.11648/j.jgo.20190701.12

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AMA Style

Masato Nishida, Hiroya Itagaki, Yasuo Otsubo, Yuko Arai. Conservative Surgery in the Management of Adenomyosis. J Gynecol Obstet. 2019;7(1):8-16. doi: 10.11648/j.jgo.20190701.12

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@article{10.11648/j.jgo.20190701.12,
  author = {Masato Nishida and Hiroya Itagaki and Yasuo Otsubo and Yuko Arai},
  title = {Conservative Surgery in the Management of Adenomyosis},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {7},
  number = {1},
  pages = {8-16},
  doi = {10.11648/j.jgo.20190701.12},
  url = {https://doi.org/10.11648/j.jgo.20190701.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20190701.12},
  abstract = {Since 2002, we have performed adenomyomectomy for 1780 women with uterine adenomyosis. We classified adenomyosis in these patients as focal (n=1313), diffuse (n=450) or cystic (n=17) type according to the distribution of the focuses seen in magnetic resonance imaging  (MRI) findings. Three different surgical methods for focal, diffuse and cystic adenomyosis are utilized at our institution. The adenomyosis lesion is excised using a loop electrode of a high-frequency cutter in all methods. The median resected lesion weight of focal, diffuse and cystic adenomyosis were 94 g (1-1156 g), 150 g (10-1595 g), and 16 g (3-45 g), respectively. The mean visual analogue score for dysmenorrhea decreased from 9.1 to 1.0 and heavy menstrual bleeding was improved in all cases. Following the procedure, 370 pregnancies occurred in 294 patients, of which 153 (41.9%) were the result of natural conception. Pregnancy rate of the patients younger than 40 years were 35.1% in focal type, 25.4% in diffuse type and 88.9% in cystic type. Among those patients, we experienced 5 cases of uterine rupture. Of 1462 patients who underwent surgery more than 2 years prior to the time of writing, recurrence occurred in 150 (10.3%). Our findings indicate that conservative surgery for uterine adenomyosis using a high-frequency resection device is effective for both focal and diffuse type.},
 year = {2019}
}

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