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Conservative adenomyomectomy with transient occlusion of uterine arteries for diffuse uterine adenomyosis
Author(s) -
Kwon YongSoon,
Roh Hyun Jin,
Ahn Jun Woo,
Lee SangHun,
Im Kyong Shil
Publication year - 2015
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12649
Subject(s) - medicine , adenomyosis , surgery , uterus , blood loss , hysteroscopy
Aim 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. Material and Methods Twenty‐six patients with symptomatic diffuse uterine adenomyosis underwent adenomyomectomy with TOUA by a single surgeon at U lsan U niversity H ospital between M ay 2011 and S eptember 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. Results 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. Conclusions Adenomyomectomy with TOUA could be a safe and effective surgical method in women with symptomatic diffuse uterine adenomyosis to preserve fertility.