Evaluation On The Efficacy Of A Double-flap Method Of Adenomyomectomy For Diffuse Uterine Adenomyosis

Objective:To evaluate the efficacy of adenomyomectomy by using a double-flap method to radically excise adenomyotic tissues for diffuse uterine adenomyosis.Methods:Investigating the clinical data of forty-four women with diffuse uterine adenomyosis were treated by a double-flap method of adenomyomectomy in Women’s Hospital, School of Medicine, Zhejiang University from April2012to October2013, whose preoperative imaging were diagnosed as diffuse adenomyosis and postoperative pathological diagnosis of adenomyosis. Their hypermenorrhea, dysmenorrhea, serum CA125and uterine size were comparatively evaluated before and after surgery.Results:The average age of the forty-four women with adenomyosis all married is (38.11±5.03) years old, of which twenty-six cases were associated with endometriosis, fifteen cases were combined with uterine fibroids and twenty-five cases had previous abdominal surgery. All of the forty-four women have varying degrees of dysmenorrhea and hypermenorrhea history, while twenty-four cases were anemia(10.69±2.31g/L). Except for three cases, all of the women were finished procreation, in which two patients have re-birth requirment. All of the forty-four women had a significant reduction of their serum CA125levels, uterine size, hypermenorrhea and dysmenorrhea whether women were treated with GnRHa or not after surgery (P<0.05). The uterine size at1-month follow up was greater than any other month follow up (P<0.05), but the differences did not reach statistical significance for serum CA125levels, hypermenorrhea or dysmenorrhea (P>0.05). No major complications or sequelae were observed.Conclusions:The double-flap method of adenomyomectomy resulted in a dramatic reduction in symptoms and may be a good therapeutic option for women with diffuse uterine adenomyosis who wish to avoid hysterectomy.