Conservative adenomyomectomy with transient occlusion of uterine arteries for diffuse uterine adenomyosis. Issue 6 (16th December 2014)

• Record Type: Journal Article
• Authors: Kwon, Yong‐Soon; Roh, Hyun Jin; Ahn, Jun Woo; Lee, Sang‐Hun; Im, Kyong Shil
• Is Part Of: Journal of obstetrics and gynaecology research. Volume 41:Issue 6(2015:Jun.)
• Page Start: 938
• Page End: 945
• Publication Date: 2014-12-16
• Subjects: Gynecology -- Periodicals; Obstetrics -- Periodicals; 618.1005
• DOI: 10.1111/jog.12649
• Languages: English
• ISSNs: 1341-8076

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jog12649-sec-0001" sec-type="section"> <title>Aim</title> <p>This study aimed to determine the feasibility and safety of adenomyomectomy with transient occlusion of uterine arteries (TOUA) in patients with symptomatic diffuse uterine adenomyosis.</p> </sec> <sec id="jog12649-sec-0002" sec-type="section"> <title>Material and Methods</title> <p>Twenty‐six patients with symptomatic diffuse uterine adenomyosis underwent adenomyomectomy with TOUA by a single surgeon at Ulsan University Hospital between May 2011 and September 2012. Surgical outcomes included operative time, intraoperative injury to blood vessels, nerves, and pelvic organs and operative blood loss. We assessed the degree of improvement in dysmenorrhea and menorrhagia at the 4‐month follow‐up after completion of adjuvant gonadotrophin‐releasing hormone agonist.</p> </sec> <sec id="jog12649-sec-0003" sec-type="section"> <title>Results</title> <p>The mean age of patients was 37.73 years (range, 27–49 years). The mean total surgical time was 95.0 min (range, 60–145 min; SD, 34.49). The mean estimated blood loss was 191.54 mL (range, 80–400 mL; SD, 110.91) and there were no cases of injury to the uterine arteries or pelvic nerves. The mean time of TOUA was 9.79 min (range, 6–16 min; SD, 2.74). The mean duration of hospital stay was 5.65 days (range, 4–7 days; SD, 0.85). There were no major complications requiring reoperation or readministration during the mean follow‐up period of 13.5 months. At the 7‐month follow‐up after adenomyomectomy with TOUA, complete remission of dysmenorrhea and menorrhagia was observed in 94.4% and 100% of patients, respectively.</p> </sec> <sec id="jog12649-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Adenomyomectomy with TOUA could be a safe and effective surgical method in women with symptomatic diffuse uterine adenomyosis to preserve fertility.</p> </sec> </abstract>