Clinical Research On Treatment Of Adenomyosis By Combination Mirena With MURU

Objective: To observe the effect and safety for treatment adenomyosis by combinationmajor uterine wall resection and reconstruction of the uterus (MURU) with mirena, andfor the further purpose of providing the basis of the tentative idea to treatmentadenomyosis according to the indexing and uterine reservationMethods: patients of adenomyosis were divided into as mild, moderate and severe levelsaccording to the maximum single-side muscle thickness (front, back and bottom of uterine)or diameter of adenomyoma by B-ultrasound device.70cases patients with moderate andsevere degree were selected and treated with MURU operation, and thelevonorgestrel-releasing intrauterine system (LNG-IUS) was intrauterine placed just inMURU.The operative duration, the volume of blood loss, the weight and volume ofresected lesion tissue were recorded. The scores of dysmenorrhea, menstrual blood volume,the volume of uterine and CA125pre-and post MURU+LNG-IUS treatment in differentobservation time (3,12and18months after treatment) were investigated and analyzed.Result:70patients were successfully treated with MURU. The average operation time,bleeding amount and hospital duration were143.76±27.00min、52.39±14.79ml and4.60±0.57drespectively. The average uterine volumes before MURU were267.57±107.18cm3.The mean weight and volumes of the resected uterine wall (lesiontissue) by MURU were310.35±71.26g and214.63±106.15cm3. Compared with the normaluterus in women of child-bearing age, the average uterine volumes were reduced about3.42times and the weight of the resected uterine walls was5.17times after MURU.3,12and18months after treatment, the scores of dysmenorrhea and menstrual blood volume,CA125level and uterine volume were significantly lower than those of pre-operation(P<0.05). No LNG-IUS exfoliation, incarceration and ectopia were observed in all patients after operation. All patients have no evident obesity, fever, vaginal dryness andalgopareunia were observed in the closely followed-up after MURU+LNG-IUS treatment.Conclusion: MURU should be a safe operation, and the effects of combination MURUwith IUS to treatment moderate and severe adenomyosis was very well.