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Combination of microwave endometrial ablation and postoperative dienogest administration is effective for treating symptomatic adenomyosis
Author(s) -
Ota Kuniaki,
Takahashi Toshifumi,
Shiraishi Satoru,
Mizunuma Hideki
Publication year - 2018
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.13720
Subject(s) - dienogest , medicine , adenomyosis , adenomyoma , visual analogue scale , microwave ablation , endometrial ablation , clinical endpoint , endometriosis , pelvic pain , urology , ablation , uterus , gynecology , surgery , randomized controlled trial
Abstract Aim Menorrhagia and dysmenorrhea are common symptoms. Uterine adenomyosis is one of the causes of menorrhagia and dysmenorrhea. These symptoms often decrease the quality of life in women. Microwave endometrial ablation (MEA) is a recently developed procedure that enables endometrial ablation. Dienogest has long been used to suppress endometrium development and reduce adenomyosis‐related dysmenorrhea. However, some cases could be resistant to dienogest. In this study, we evaluated the efficacy of a combination of MEA and postoperative dienogest in reducing adenomyosis‐related dysmenorrhea and menorrhagia. Methods Ten patients with hormone treatment‐resistant symptomatic adenomyosis underwent MEA and were administered oral dienogest after the procedure. The primary endpoints were reduction in pain recurrence and anemia. The secondary endpoint was a change in the adenomyosis lesion and its symptomatic recurrence. Results Statistically significant improvements were seen in the visual analog scale score and hemoglobin levels in women post‐treatment. The difference in myometrial thickness pre‐ and post‐MEA was statistically significant. There were no cases of symptomatic recurrence. Conclusion The combination of MEA and postoperative dienogest is useful for treating uterine adenomyosis with menorrhagia and dysmenorrhea.