Retrospective Clinical Analysis Of1014Cases Of Uterine Adenomyosis Leading To Hysterectomy

Objective: This article collects and analyzes1014patients withuterine adenomyosis leading to hysterectomy from Jan.2009to Dec.2014in No.2hospital of Jilin University. Analysis to discuss the evidence ofhysterectomy and the rationality of the treatment,so as to help clinicaldoctors improve the treatments of uterine adenomyosis in the future.Method:1.Medical records of1014patients with uterine adenomyosis leadingto hysterectomy in these six years were retrospectively analyzed.2.Use the EXCEL software to create tables and record the clinicaldata according to the following key words: year of hospitalization, age,family history, menstrual quantity, dysmenorrhea, menstrual conditions(continuous days/cycle number of days), the other symptoms (such ascompression symptoms, pain during sex), always treatment, ultrasonicsize of the uterus, cervical liquid based cells of department ofgynaecology check (TCT), HPVDNA examination, complications,hysterectomy operation and other factors.3.Statistical methods: The data were statistically processed by usingSPSS19.0statistical software, the mean plus or minus, dynamic sequenceof variance and chi-square analysis.Difference was statistically significant (P <0.05).Results:In the study of1014cases, the average age was44.4±4.8years old, mainly distributed in two groups which were41-45and46-50.Each group accounted for37%and34%.88.3%of the patients hadvolume increase, about32.6%of patients with secondary anemia.86.5%of patients were in the secondary dysmenorrhea symptoms,37.3%ofpatients were with lumbar abdominal pain.781patients had histories ofmiscarriage, about25%of patients had more than3times of history ofabortion.21%of patients had symptomatic treatments before surgery,4.9%of patients had oral sex hormone treatments to adjust menstruationperiod.3.7%of patients had Mirena,2.9%of patients had diagnosticcurettage,67.5%of patients without any treatment directly chosehysterectomy. All patients had preoperative gynecological ultrasonicexamination,876cases of patients had TCT examination,621cases ofpatients with HPV DNA examination. Gynecology ultrasound diagnosticaccuracy was88.8%. There are821cases of subtotal hysterectomy,193cases of total hysterectomy. There are543cases by abdominalhysterectomy(53.6%),433cases by laparoscopic surgery(42.7%),38cases by vaginal surgery(3.7%).71.1%of the patients under45years oldhad subtotal hysterectomy,74.0%of the patients beyond45years old hadtotal hysterectomy. Postoperative pathological negative rate was11.0%.Conclusion:The increased menstrual quantity and secondary dysmenorrhea are the major surgical indications. In the radical surgicaltreatments, patients under45years old mainly accepted subtotalhysterectomy as a condition of patients aged beyond45years old withtotal hysterectomy.91.5%of patients conform to the operation.8.5%ofthem who can be treated with other methods accepted surgical treatment.Most of the patients had clear operation indications. The wide use ofMirena can reduce the rate of surgeries.