Local excision of uterine adenomyomas: a report of 86 cases with follow-up analyses.

OBJECTIVE

To assess the outcomes of patients who underwent local excision of adenomyoma and to evaluate the effectiveness of the procedure.

STUDY DESIGN

Prospective study of 86 women undergoing local excision of symptomatic uterine adenomyoma at laparotomy. Dysmenorrhea was assessed before and after operation by questionnaire, and the average duration of follow-up was 24 months.

RESULT(S): At 6-month follow-up, all 86 patients' dysmenorrhea grades were reduced by more than 80%. With a mean follow-up of 24 (range 6-60) months, a total of 2 (2.3%) patients finally underwent hysterectomy, 1 (1.2%) received levonorgestrel-releasing intrauterine device therapy, and three patients (11.3%) were subsequently given treatment with oral pain medication alone. The mean time interval between local excision and subsequent treatment was 34 months. Two (2.3%) patients became pregnant after the local excision: one (1.2%) at 2 months after the procedure and one (1.2%) at 3 years after the local excision procedure.

CONCLUSION(S): Local excision of uterine adenomyoma remains a safe and effective minimally invasive treatment for women with symptomatic uterine adenomyoma. Local excision can effectively alleviate the dysmenorrhea of adenomyoma.