Adenomyosis - An Update in New Treatment Strategies
Journal Title: Indian Obstetrics & Gynaecology - Year 2016, Vol 6, Issue 4
Abstract
Adenomyosis uteri is a common gynaecological disorder with unclear aetiology and is characterized by the presence of ectopic endometrial glands and stroma in the myometrium with adjacent smooth muscle hyperplasia. Classically the diagnosis was possible only in hysterectomy specimens with suggestive histopathology and also in hysterectomies of infertile women compromising the fertility. Today an accurate diagnosis of adenomyosis can be made due to advances in imaging techniques like high resolution vaginal ultrasound and MRI. Though hysterectomy is the definitive treatment, there is a need for conservative uterine sparing surgery in reproductive age group women to preserve fertility and relieve symptoms. Medical treatment is effective in relieving symptoms, however the effect is transient and rapid regrowth of adenomyosis occurs with recurrence of symptoms once the treatment is stopped. There is a need for conservative uterine sparing surgery. Conservative surgery involving endo-myometrial ablation, laparoscopic myometrial electrocoagulation or excision has proven to be effective in more than fifty percent of the cases, though hysterectomy may still be necessary in severe cases. Early diagnosis may improve treatment outcome. Much progress has been made in the understanding of adenomyosis over the last two decades. Conservative management of adenomyosis is currently an important issue.
Authors and Affiliations
Dr. P. Reddi Rani, Dr Chandana G
Keywords
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