Huang F J, Kung F T, Chang S Y, Hsu T Y
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taiwan.
J Reprod Med. 1999 Aug;44(8):741-4.
Hysterectomy and hysteroscopic endometrial ablation remain common treatment of symptomatic adenomyosis for women who have completed childbearing. However, for patients who wish to avoid surgery and in whom adenomyosis is suspected of causing infertility, repeated abortion or physical symptoms, medical treatment with gonadotropin-releasing hormone analogue (GnRH-a) should be considered.
Two cases of documented adenomyosis were suspected of causing infertility; both were treated with a three-month course of GnRH-a via a nasal spray. Both patients experienced relief of symptoms and conceived within six months of the cessation of treatment.
The efficacy and safety of a short course of GnRH-a treatment of adenomyosis may be considered in patients who take less time than others to achieve a significant reduction of uterine size and relief of symptoms and in those who develop side effects.
子宫切除术和宫腔镜子宫内膜切除术仍然是已完成生育的有症状子宫腺肌病女性的常见治疗方法。然而,对于希望避免手术且怀疑子宫腺肌病导致不孕、反复流产或身体症状的患者,应考虑使用促性腺激素释放激素类似物(GnRH-a)进行药物治疗。
两例确诊子宫腺肌病的患者被怀疑导致不孕;二者均通过鼻喷雾剂接受了为期三个月的GnRH-a治疗。两名患者症状均得到缓解,并在治疗停止后的六个月内受孕。
对于子宫大小显著缩小和症状缓解所需时间比其他人短以及出现副作用的患者,可考虑短期使用GnRH-a治疗子宫腺肌病的有效性和安全性。