Approaches to adenomyomectomy

Publication date: Available online 2 April 2015 Source:Gynecology and Minimally Invasive Therapy Author(s): Serene Thain , Heng Hao Tan Adenomyosis is a common gynecological condition that affects women causing menstrual disturbances, pain and subfertility. Adenomyomectomy as an alternative to hysterectomy has been widely performed in those who have not completed childbearing or those refusing a hysterectomy for a variety of reasons. Whichever the surgical route, the challenges of adenomyomectomy include possible misdiagnosis, defining the extent of resection, technical difficulties, dealing with the associated complications and managing the risks of uterine rupture during a subsequent pregnancy. The principles of surgery mimic that of myomectomy but the evolution of adenomyomectomy has been relatively unexciting with a general paucity of published data till date. Laparoscopic techniques have proven feasible generally, avoiding the risks of open surgery while conferring the benefits of microsurgery. Limitations in tactile feedback and access constraints have been the main drawbacks via this route. Meticulous stitching and repair is still of paramount importance in these operations. Pre-operative gonadotrophin-releasing hormone agonists (GnRHa) have proven effective in shrinking the disease and reducing blood loss during surgery, while the post-operative usage has resulted in a dramatic reduction in symptoms. Uterine artery ligation techniques have also been shown to be ...
Source: Gynecology and Minimally Invasive Therapy - Category: OBGYN Source Type: research