Local excision of uterine adenomyomas: a report of 86 cases with follow-up analyses

Objective: To assess the outcomes of patients who underwent local excision of adenomyoma and to evaluate the effectiveness of the procedure. Study design: Prospective study of 86 women undergoing local excision of symptomatic uterine adenomyoma at laparotomy. Dysmenorrhea was assessed before and after operation by questionnaire, and the average duration of follow-up was 24 months. Result(s): At 6-month follow-up, all 86 patients' dysmenorrhea grades were reduced by more than 80%. With a mean follow-up of 24 (range 6-60) months, a total of 2 (2.3%) patients finally underwent hysterectomy, 1 (1.2%) received levonorgestrel-releasing intrauterine device therapy, and three patients (11.3%) were subsequently given treatment with oral pain medication alone. The mean time interval between local excision and subsequent treatment was 34 months. Two (2.3%) patients became pregnant after the local excision: one (1.2%) at 2 months after the procedure and one (1.2%) at 3 years after the local excision procedure. Conclusion(s): Local excision of uterine adenomyoma remains a safe and effective minimally invasive treatment for women with symptomatic uterine adenomyoma. Local excision can effectively alleviate the dysmenorrhea of adenomyoma. (C) 2011 Elsevier Ireland Ltd. All rights reserved.