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Semin Reprod Med 2020; 38(02/03): 157-167
DOI: 10.1055/s-0040-1718921
Review Article

Current and Future Surgical and Interventional Management Options for Adenomyosis

Joseph Chen
1   Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Anne E. Porter
2   Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
,
Kimberly A. Kho
3   Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
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Abstract

Historically, hysterectomy has been the recommended treatment for patients with adenomyosis. However, in the past two decades, various uterine-sparing treatment methods have emerged. These range from excisional techniques such as adenomyomectomy or wedge resection to uterine artery embolization, radiofrequency thermal ablation, hysteroscopic excision, endometrial ablation, and high-intensity focused ultrasound. While largely investigative for the treatment of adenomyosis, these procedures have demonstrated improvement in symptoms including abnormal uterine bleeding, dysmenorrhea, pelvic pain, and overall quality of life. However, long-term data including fertility and obstetric outcomes are needed. Future research is needed to better understand the impact of these uterine-preserving techniques to expand our armamentarium for the treatment of adenomyosis.

Keywords

adenomyosis - adenomyomectomy - uterine preservation - surgery - outcomes - uterine artery embolization - radiofrequency thermal ablation - high-intensity focused ultrasound


Publication History

Article published online:
05 November 2020

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