Department of Obstetrics and Gynecology, General Faculty Hospital, First Faculty of Medicine, Charles University, Apolinarska, Prague, Czech Republic (all authors).
Department of Obstetrics and Gynecology, General Faculty Hospital, First Faculty of Medicine, Charles University, Apolinarska, Prague, Czech Republic (all authors).
J Minim Invasive Gynecol. 2022 Mar;29(3):392-400. doi: 10.1016/j.jmig.2021.10.005. Epub 2021 Oct 17.
Women with adenomyosis may show a lower pregnancy rate and a higher miscarriage rate than healthy women. There is also a general agreement that leiomyomas, either submucosal or intramural, negatively affect fertility, when compared with women without myomas. Some of these women may benefit from adenomyomectomy, however this cytoreductive procedure is considered invasive and technically challenging especially in severe diffuse cases. The study aimed to compare the clinical and reproductive outcomes of patients who underwent adenomyomectomy with those of patients who underwent intramural myomectomy.
A retrospective study.
Department of Obstetrics & Gynecology, Center of Gynecological Endoscopy and Minimally Invasive surgery, First Faculty of Medicine, General University Hospital in Prague.
A total of 55 women who underwent surgical resection of uterine adenomyosis and 55 patients who underwent myomectomy for intramural uterine myomas were included in this study. All study participants wished to retain and possibly improve their reproductive potential.
Between 2004 and 2019, 110 women underwent laparoscopic or open uterus-sparing surgery for clinically significant uterine adenomyosis (group A) or myomas (group B), respectively.
Two groups of women who underwent different fertility-saving procedures were compared. Although all women entering the study had declared their wish to conceive, only 28 patients in group A (group A1) and 24 women in group B (group B1) finally aimed toward pregnancy. The mean age and follow-up period was 35.0 years and 76.81 months, respectively, in group A and 34.8 years and 72.5 months, respectively, in group B. The pregnancy and delivery rates were 75.0% and 46.4%, respectively, in group A1 vs 96.0% and 70.8%, respectively, in group B1, with no significant differences between the 2 groups. The open surgical approach was significantly more frequently employed in group A (47.3% vs 16.4%; p <.01).
In this study, women who underwent surgery involving the uterine muscularity, including myomectomy or adenomyomectomy, had comparable reproductive outcomes, with no significant differences.
与健康女性相比，患有子宫腺肌病的女性妊娠率较低，流产率较高。人们普遍认为，与没有肌瘤的女性相比，黏膜下或壁内肌瘤会对生育能力产生负面影响。一些女性可能会受益于子宫腺肌瘤切除术，但这种细胞减少手术被认为是侵入性的，在严重弥漫性病例中技术上具有挑战性。本研究旨在比较接受子宫腺肌瘤切除术和接受子宫壁内肌瘤切除术的患者的临床和生殖结局。
回顾性研究。
布拉格第一医科大学妇产科、妇科内镜和微创手术中心。
本研究共纳入 55 例接受手术切除子宫腺肌病的女性和 55 例接受子宫壁内肌瘤切除术的患者。所有研究参与者都希望保留并可能提高其生殖潜能。
2004 年至 2019 年，110 例患有临床显著子宫腺肌病的女性（A 组）或子宫肌瘤的女性（B 组）分别接受腹腔镜或开腹子宫保留手术。
比较了两组接受不同生育保存手术的女性。尽管所有进入研究的女性都宣布了她们想要怀孕的愿望，但只有 A 组的 28 例患者（A1 组）和 B 组的 24 例女性（B1 组）最终希望怀孕。A 组的平均年龄和随访时间分别为 35.0 岁和 76.81 个月，B 组分别为 34.8 岁和 72.5 个月。A1 组的妊娠和分娩率分别为 75.0%和 46.4%，B1 组分别为 96.0%和 70.8%，两组间无显著差异。开放式手术在 A 组中明显更为常见（47.3%比 16.4%；p<.01）。
在这项研究中，接受涉及子宫肌层的手术的女性，包括子宫肌瘤切除术或子宫腺肌瘤切除术，其生殖结局相似，无显著差异。
