Hiratsuka Daiki, Ishizawa Chihiro, Iida Rei, Fukui Yamato, Matsuo Mitsunori, Nishida Masato, Ikemura Masako, Harada Miyuki, Wada-Hiraike Osamu, Osuga Yutaka, Hirota Yasushi
Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Obstetrics and Gynecology, National Hospital Organization, Kasumigaura Medical Center, Kasumigaura, Japan.
J Obstet Gynaecol Res. 2025 Jan;51(1):e16185. doi: 10.1111/jog.16185.
Uterine adenomyosis is a common disease in women of reproductive age that causes dysmenorrhea, abnormal uterine bleeding, infertility, and obstetric complications. Rarely, adenomyosis can lead to abscess formation, which is refractory to antibiotics and occasionally requires surgical treatment, such as hysterectomy. However, hysterectomy should be avoided in patients who seek to preserve fertility. Herein, for the first time, we report two cases of uterine adenomyosis with abscess formation during assisted reproductive procedures that were successfully treated with adenomyomectomy, thereby preserving fertility. A history of repeated intrauterine procedures and infections was crucial in making an appropriate preoperative diagnosis. Adenomyomectomy can be an effective treatment for adenomyosis associated with abscess in patients who wish to preserve fertility.
子宫腺肌病是育龄期女性的常见疾病，可导致痛经、异常子宫出血、不孕和产科并发症。罕见情况下，腺肌病可导致脓肿形成，对抗生素治疗无效，偶尔需要手术治疗，如子宫切除术。然而，对于有生育需求的患者应避免进行子宫切除术。在此，我们首次报告两例在辅助生殖过程中发生子宫腺肌病合并脓肿形成的病例，通过腺肌病切除术成功治疗，从而保留了生育能力。反复的宫腔操作和感染史对于做出准确的术前诊断至关重要。对于希望保留生育能力的腺肌病合并脓肿患者，腺肌病切除术可能是一种有效的治疗方法。
