Combined Results of New Surgery Approach and Hormone Therapy with Massive Diffuse Forms of Adenomyosis

Abstract

Uterine adenomyosis is a gynecologic condition whose diagnosis and clinical significance remains somewhat enig¬matic [1-3]. Adenomyosis is defined as a benign invasion of the endome¬trium into the myometrium, producing a diffusely enlarged uterus, which microscopically exhibits ectopic, nonneoplastic endometrial glands and stroma surrounded by the hypertrophic and hyperplastic myometrium [4]. The role of surgery in managing extensive uterine adenomyosis and subfertility is still highly controversial, partly because the diagnosis of adenomyosis has always been retro¬spective, and adenomyosis often involves the whole uterus diffusely, with difficulty separating normal myometrial tissue from myometrial tissue invaded by adenomyosis [5-9]. In 2011 a Japanese professor Hisao Osada published an observation of conducted organ-preserving surgical treatment of patients with adenomyosis in the period from 1998 to 2008 [10]. In July 2012, for the first time, we performed the operation of adenomyomectomy with the reconstruction of the uterus wall by three-flap method proposed by Hisao Osada. Objective