Uterus sparing surgery in adenomyosis and its impact on reproductive outcomes

Abstract

ABSTRACT

Objective: The purpose of this study was to evaluate the appropriate surgical treatment of

adenomyosis and its impact on reproductive outcomes

Design: review of the literature

Setting: Department of Obstetrics and Gynecology, General University Hospital, First Faculty of Medicine, Charles University, Prague

Conclusion: Patients with adenomyosis and fibroids may show a lower pregnancy rate and higher miscarriage rate than healthy individuals. However, there is no standard protocol for their optimal treatment, particularly in pregnancy-seeking or infertile women. Myomectomy is generally commonly performed procedure that preserves fertility. On the other hand, the role of surgery in extensive uterine adenomyosis remains controversial, because adenomyosis often involves the whole uterus diffusely. It is almost impossible to remove all pathological tissue from the surrounded myometrium. Therefore, this procedure is called debulking/cytoreductive surgery. However, also adenomyomectomy has become more common type of surgical intervention in recent years.