O-33: Usage, Development and Effectiveness of A New Surgical Technique for The Treatment of Severe Adenomyosis
Advised treatment of the severe forms of Adenomyosis is Hysterectomy but for the patients that want to preserve their uterus, conservative surgery named “Adenomyomectomy” for removal of endometrial tissue from the myometrium can be performed. This technique must be developed for reduction of the spontaneous uterine rupture, adhesions and recurrence rate. So, this study is to investigate the safety and therapeutic outcomes of different and novel adenomyomectomy technique.
Materials and methods
Prospectively, 103 Iranian patients with documented severe adenomyosis were candidates for adenomyomectomy over a period of 7 years (April 2004 -March 2011). The surgical procedure is the resection of adenomatous lesions with the thin (0.5 cm) margin, wedge shaped in two sides of the uterus wall, with sagittal incision on the body of the uterine and reconstruction of the layers and inverted suture for the serosa layer ends.
Out of 103 patients, 57 cases (55.34%) were presented with infertility, 17 cases (16.5%) with IVF failure, 9 cases (8.74%) with recurrent abortion and 20 cases (19.42%) with Abnormal Vaginal Bleeding (AUB). Out of 70 patients that wish to bear child, 21 persons (30%) become pregnant; spontaneously (7 cases) or by ART technique (14 cases). 16 pregnancies became full term and candidates for cesarean section (C/S). There was a significant reduction in both dysmenorrhoea and hypermenorrhoea. Only one case had relapsed adenomyosis.
Adenomyomectomy is the conservative and effective option on treatment of adenomyosis. The described procedure in this study can be an efficient procedure for the treatment of severe adenomyosis.