Page 52 - ESHRE2019

Conservative Surgical procedures for adenomyosis
• Adenomyomectomy
•
• • • •
“Cytoreductive surgery” for extensive adenomyosis – Wedge resection
– U incision
– H incision
– Double and triple flaps Coagulation of adenomyosis
Endomyometrial resection Uterine artery embolization MRgFUS
Osada et al. 2011
Al Jama et al. 2011
Sun et al. 2011
Wang et al. 2009 (53)
Wang et al. 2009 (54)
Fedele et al. 1993
Fujishita et al. 2004
Takeuchi et al. 2006
Takeuchi et al. 2010
24
36
24
24
52.7 ± 22.2
36
NA
35
26
18
24
Surgical‐ 27 Surgical and medical ‐ 44
28
4
8
3
16/26 (61%)
8/18 (44.4%)
8/24 (33.3%)
20/27 (74%) 35/44
(79.5%)
13/28 46.4%)
18/28 64.2%)
2/4 (50%)
2/8 (25%)
3/3 (100%)
16/21 (76%)
14/16 87.5%)
6/8 (75%)
3/8 (37.5%)
17/20 (85%) 32/35 (91%)
9/13 (32.1%)
9/18 (50%)
2/2 (100%)
2/2 (100%)
3/3 (100%)
4/21 (19%) 2 uterine ruptures
2/16 (12.5%)
2/8 (25%)
5/8 (62.5%)
3/20 (15%) 3/35 (8.5%)
4/13 (14.3%)
7/18 (38.8%)
0
13
Authors
Saremi et al. 2014
Follow up (months)
24
Desired pregnancy
70 (49 IVF)
Pregnancy rate
(%)
21/70 (30%)
Live birth rate
(%)
Miscarriage rate (%)
14
50
47