Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. The type of hysterectomy was categorized as either open surgery (i.e., AH) or LH. Bazot M, Darai E, Rouger J, Detchev R, Cortez A, Uzan S. Limitations of transvaginal sonography for the diagnosis of adenomyosis, with histopathological correlation. These are second-line treatment options aiming to cure symptoms and preserve the uterus in patients with failed medical therapy. Short-term improvement was achieved in 89.6% of patients with pure adenomyosis and 94.3% of patients with adenomyosis with fibroids, while long-term improvement was achieved in 74.0% of patients with pure adenomyosis and 84.5% of patients with adenomyosis with fibroids [109]. As a library, NLM provides access to scientific literature. One of our studys limitations is the small sample size given the relatively brief study period (i.e., 1year) and the small proportion of patients who met the eligibility criteria and provided informed consent during this period. In many parts of the world, UAE is performed under conscious sedation. Fan TY, Zhang L, Chen W, et al. Ultrasound Obstet Gynecol 10.1002/uog.19096 [. Uterine artery embolization (UAE) in patients with symptomatic adenomyosis has demonstrated to reduce symptoms and improve quality of life. Cezar C, Torres de la Roche LA, Hennefrnd J, Verhoeven HC, Devassy R, De Wilde RL; Working Group on Minimally Invasive Therapy in Benign Disease of the Uterine Wall (European Society of Gynecological Endoscopy, ESGE). Yuan K, Zhang JL, Yan JY, Yuan B, Fu JX, Wang Y, Sun XD, Guan Y, Duan F, Wang MQ. HHS Vulnerability Disclosure, Help 2022 Nov 25;96(1143):20220121. doi: 10.1259/bjr.20220121. The site is secure. See this image and copyright information in PMC. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Tan J, Moriarty S, Taskin O, et al. Endovascular embolization of uterine myomas and adenomyomatosis is a safe and effective organ-sparing treatment for symptomatic patients based on a broad range of published evidence including randomized-controlled trials. 2006 Mar;33(1):125-44. doi: 10.1016/j.ogc.2005.12.009. Unauthorized use of these marks is strictly prohibited. Debulking/cytoreductive surgeries aim to remove visibly diseased tissue with repair of the remaining myometrial tissue [65]. Bethesda, MD 20894, Web Policies The purpose of this study is to clarify its minimal invasive features using a patient questionnaire on the postoperative quality of life (QOL) over various time periods following either laparoscopic hysterectomy (LH) or abdominal hysterectomy (AH) and to compare the results. The calculated sample size for this trial was 96 patients (divided into 52 embolization and 34 hysterectomy, including a 10% expected drop-out) made on assumptions from the embolization versus hysterectomy (EMMY) trial outcomes [111]. Understanding adenomyosis: a case control study. Similarly, no significant differences were found between the two groups in terms of operative time, blood loss, uterine weight, or rate of operative complications. Exclusion criteria were patients under 18years of age, pelvic infection, suspected or confirmed malignancy, current or future desire to conceive, any absolute contraindication to angiography, deep infiltrating endometriosis requiring surgery or obstructing the bowel, or coexisting hysteroscopically removable submucous fibroids. showed 75% symptom relief on short-term follow-ups [77]. volume21, Articlenumber:219 (2021) In accordance with refined diagnostic tools such as ultrasound and/or MRI, minimally invasive treatments for adenomyosis are being explored. 2020;223(543):e114. Namiki S, Egawa S, Terachi T, Matsubara A, Igawa M, Terai A, et al. The authors declare that they have no competing interests. Zullo F, Palomba S, Russo T, Falbo A, Costantino M, Tolino A, et al. Efficacy of high-intensity focused ultrasound ablation for adenomyosis therapy and sexual life quality. Zhou M, Chen JY, Tang LD, Chen WZ, Wang ZB. With randomized controlled trials and more evidence-based research, optimal treatment protocols can be developed according to patient needs. Among the main treatment strategies, there are hormone therapy, hysterectomy, myomectomy, and uterine artery embolization (UAE), a recent and promising treatment for patients who wish to avoid hysterectomy. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. 1. Uterine Artery Embolization Versus Hysterectomy in the Treatment of Symptomatic Adenomyosis: Protocol for the Randomized QUESTA Trial. Your privacy choices/Manage cookies we use in the preference centre. Fukuhara S, Ware JE, Kosinski M, Wada S, Gandek B. Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. To date, UAE seems to be the most investigated and highest potential minimally invasive treatment option for adenomyosis. The authors declare that they have no competing interests. In addition, Ferrari et al. The study was performed in accordance with the Declaration of Helsinki ethical standards and was approved by the institutional review boards of the Kindai University Hospital and Kindai University Nara Hospital, respectively, after obtaining written informed consents from the participants (R24-036 and R24-058). Andersen MH, Mathisen L, Veenstra M, Oyen O, Edwin B, Digernes R, et al. A prospective cohort study of total prostatectomy in Japan used the SF-36 and self-rating of sexual function in postoperative months 1, 3, 6, and 12 and revealed no significant differences between laparoscopic and open surgery [6]. Europe PMC is an archive of life sciences journal literature. Transplantation. Purpose of Review This review will examine the use of uterine artery embolization (UAE) for the management of adenomyosis (AUB-A) and evaluate its advantages and disadvantages. J Clin Epidemiol. Popovic M, Puchner S, Berzaczy D, Lammer J, Bucek RA. Unable to load your collection due to an error, Unable to load your delegates due to an error. Uterine artery embolization versus hysterectomy in the treatment of symptomatic adenomyosis: protocol for the randomized questa trial. Uterine artery embolization (UAE) in patients with symptomatic adenomyosis has demonstrated to reduce symptoms and improve quality of life. A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic. Matsumoto Y, Iwasaka T, Yamasaki F, Sugimori H. Apoptosis and Ki-67 expression in adenomyotic lesions and in the corresponding eutopic endometrium. Transvaginal ultrasound (TVS) represents a cost-effective initial screening modality for adenomyosis. New interventional techniques for adenomyosis. Jingqi W, Lu Z, Jun Z et al (2018) Clinical usefulness of the microbubble contrast agent SonoVue in enhancing the effects of high-intensity focused ultrasound for the treatment of adenomyosis. The main advantage of medication is symptomatic relief without the need for surgical treatment. doi: 10.3205/iprs000157. Patients who underwent LH scored significantly higher on physical functioning on postoperative day 3 and week 2; physical role and bodily pain on day 3 and week 1; general health on postoperative day 3, weeks 1, 2, and 4, and month 6; social functioning on day 3; and emotional role on day 3 and week 1. Since then, literature has shown promising results regarding symptom relief and uterine preservation with few reported complications (namely pain, numbness, vaginal or urinary discharge, fever, skin burn, or contact dermatitis) [83]. @article{osti_21608522, title = {Uterine Artery Embolization versus Myomectomy: Impact on Quality of Life-Results of the FUME (Fibroids of the Uterus: Myomectomy versus Embolization) Trial}, author = {Manyonda, Isaac T., E-mail: imanyond@sgul.ac.uk and Bratby, Mark and Horst, Jessica S and Banu, Nassera and Gorti, Maha and Belli, Anna-Maria}, abstractNote = {Purpose: This study was designed to . Careers, Unable to load your collection due to an error. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. http://creativecommons.org/licenses/by/4.0/, Myometrial foci of high signal intensity on T1-weighted images, Poor definition of the endometrial-myometrial interface, Diffuse myometrial heterogeneity associated thin hypoechoic linear striations within a heterogeneous myometrium, Diffuse asymmetric or symmetric widening of the myometrial walls, Large, regular, asymmetric uterus without leiomyomas, Quality of Life after Embolization vs Hysterectomy in Adenomyosis. With the introduction of assisted reproductive techniques, delayed age of conception, and availability of minimally invasive treatment options, the shift from hysterectomy as the go to option seems inevitable. Would you like email updates of new search results? However, data concerning the impact of surgical bypass and percutaneous transluminal angioplasty . Recent research shows an enhancement in quality of life during the early years after hysterectomy. Hou Y, Qin Z, Fan K, Xu Y, Huang X. Current American College of Obstetrics and Gynecology and Society of Interventional Radiology guidelines still consider desire for future fertility a relative contraindication to UAE, but conflicting reports regarding effects of UAE on fertility [112] still give room for debate. 2005;193:134452. One in three patients with adenomyosis is asymptomatic, but the rest may present with. official website and that any information you provide is encrypted Das C, Rathinam D, Manchanda S, Srivastava D. Endovascular uterine artery interventions. This includes the temporary relieve of symptoms, and the common (i.e., menopausal symptoms, irregular bleeding, amenorrhea) and occasionally severe (i.e., thromboembolic) side effects of some drugs. Even in this period, however, the QOL was significantly greater in the LH group compared with the AH group. Kishi Y, Yabuta M, Taniguchi F. Who will benefit from uterus-sparing surgery in adenomyosis-associated subfertility? Over time, minimally invasive diagnostic and treatment methods have developed as more women desire uterine preservation for future fertility or to avoid major surgery. Similar to ultrasound, various direct and indirect features can be used to describe adenomyosis, but need more knowledge of uterine anatomy and its cyclic variations [36]. The datasets used and/or analysed during the current study available from the corresponding author on reasonable request. Shui L, Mao S, Wu Q, et al. J Obstet Gynaecol India. Uterine artery embolization for the treatment of adenomyosis: a systematic review and meta-analysis. The outcomes of the Quality of Life after Embolisation vs Hysterectomy in Adenomyosis (QUESTA) which commenced recruitment in 2015 are currently awaited (de Bruijn et al. Inclusion in an NLM database does not imply endorsement of, or agreement with, These include 2 prospective and 5 retrospective studies and 1 systematic review and meta-analysis. In the latest systematic review and meta-analysis by de Bruijn et al., patients were divided into four groups to report short- and long-term outcomes. Bergeron C, Amant F, Ferenczy A. Pathophysiology and physiology of adenomyosis. Fukunishi H, Funaki K, Sawada K, Yamaguchi K, Maeda T, Kaji Y. The symptomatology of adenomyosis. The use of complex imaging techniques has revealed various subtypes of adenomyosis, often associated with histopathologic variation in glandular and muscular components [31]. Polina L, Nyapathy V, Mishra A, Yellamanthili H, Vallabhaneni MP. This trial will provide insight for caretakers and future patients about the effect of UAE compared to the gold standard hysterectomy in the treatment of symptomatic adenomyosis and is therefore expected to improve patients' wellbeing and quality of life. Janda M, Gebski V, Brand A, Hogg R, Jobling TW, Land R, et al. The patients completed the Uterine Fibroid Symptom and Quality of Life questionnaire at baseline and at a 42-month follow-up (range 24- 71). -, Bird CC, McElin TW, Manalo-Estrella P. The elusive adenomyosis of the uterus--revisited. Because it removes the uterus completely, a hysterectomy is a definitive cure for adenomyosis. Health-related quality of life 10 years after uterine artery embolization or hysterectomy remained comparably stable. Stem cell and female reproduction. -. Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy. Uterine artery embolization for symptomatic uterine fibroids. Adenomyosis remains an underdiagnosed condition. 2015;12:CD003677. The LH group had higher scores in physical functioning on postoperative day 3 and week 2; physical role on day 3 and week 1; bodily pain on day 3 and week 1; general health on day 3, weeks 1, 2, and 4, and month 6; social functioning on day 3; and emotional (mental) role on day 3 and week 1. Conclusions: Habiba M, Benagiano G, Brosens I. Caridi TM, Spies JB. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. - Abstract - Europe PMC Europe PMC is an archive of life sciences journal literature. Tosti C, Vannuccini S, Lazzeri L, Luisi S, Petraglia F, Troa L. Current and future medical treatment of adenomyosis. Kim MD, Kim YM, Kim HC, et al. Federal government websites often end in .gov or .mil. Furthermore, initial studies have linked various imaging criteria to symptoms of adenomyosis [4951]. Currently, the RCT "Quality of Life after Embolization vs Hysterectomy in Adenomyosis" (QUESTA) trial is ongoing and results highly awaited. Prevalence and risk factors of adenomyosis at hysterectomy. Whether or not UAE can replace hysterectomy will largely depend on the results of ongoing QUESTA trial and other randomized trials comparing fertility outcomes among minimally invasive therapies. This questionnaire comprises 36 items and eight subscales, namely physical functioning, physical role (body), bodily pain, general health, vitality, social function (mental), emotional role, and mental health. Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: systematic review and metaanalysis. This multicenter non-blinded randomized controlled trial is currently ongoing in the Netherlands. Int J Gen Med. Introduction: A description is given of the quality of life (QOL) of women who were treated with peripartum embolization or hysterectomy for major obstetric hemorrhage (MOH). This study was aimed to compare serial long-term postoperative changes in quality-of-life (QoL) between photoselective-vaporization (PVP) using 120W-High-Performance-System and holmium-laser-enucleation (HoLEP) in benign-prostatic-hyperplasia (BPH) patients and to identify factors influencing the QoL improvement at the short-term, mid-term and long-term follow-up visits after surgery. Naftalin J, Hoo W, Pateman K, Mavrelos D, Foo X, Jurkovic D. Is adenomyosis associated with menorrhagia? eCollection 2021. In this study, the clinical pathway determined that LH cases should be discharged 34days after surgery and after eight days for AH cases; the majority of patients were discharged accordingly. The follow-up period will be completed two years after inclusion of the last patient. [20] then later established as an effective treatment option for patients with symptomatic uterine fibroids [21, 22]. Furthermore, diffuse adenomyosis, depth of invasion, and coexisting fibroids and/or endometriosis are associated with increased frequency/severity of symptoms and reproductive complications [31, 49, 5860]. Despite being established in fibroids as a cost-effective, short recovery alternative to surgery with minimal complications [19, 23, 100], it was believed to have lower efficacy in adenomyosis [106]. Uterine artery embolization is a well-documented and less invasive alternative to hysterectomy for symptomatic uterine fibroids on which eligible patients should be counseled. Embolization is usually performed using variable-sized permanent particulate agents [103, 104]. This multicenter non-blinded randomized controlled trial is currently ongoing in the Netherlands. Limited literature on treatment outcomes for HIFU in adenomyosis has shown highly variable results regarding symptom and uterine volume reduction [8897]. A review of characteristic imaging findings and treatment options, with an emphasis on the use of uterine artery embolization. They reported significantly higher scores in bodily pain and social functioning after laparoscopic surgery. 2000 May;95(5):68891. Uterine artery embolization: a review of current concepts. 1 QOL is an especially important consideration in the counseling, implementation, and posttreatment management of arduous treatments for life-threatening . Statistical analysis was performed using Students t-test to compare the mean values between the two groups and the 2 test to compare proportions. 1Radiology Department, Faculty of Medicine, Zagazig University, Koliat Al Tob Street, Zagazig, 44519 Egypt, 2Radiology Department, Al-Ahrar Teaching Hospital, Zagazig, Egypt. Transvaginal ultrasound for the diagnosis of adenomyosis: systematic review and meta-analysis. Parazzini F, Mais V, Cipriani S, Busacca M, Venturini P, GISE Determinants of adenomyosis in women who underwent hysterectomy for benign gynecological conditions: results from a prospective multicentric study in Italy. YK, RF, AK and MS made clinical examinations, performed surgery and accumulated data. Polyvinyl alcohol particle size for uterine artery embolization: a prospective randomized study of initial use of 350-500m particles versus initial use of 500-700m particles. Abstract. In addition, a license agreement for the use of SF-36 was signed with Health Outcomes and Process Evaluation research, and the study was conducted. Isolated adenomyotic cyst associated with severe dysmenorrhea. Bird CC, McElin TW, Manalo-Estrella P. The elusive adenomyosis of the uterus--revisited. Adenomyosis at hysterectomy: a study on frequency distribution and patient characteristics. Management of adenomyosis. The main issue with conservative surgical methods is the high risk for complications, i.e., uterine rupture and complicated pregnancy [54, 65] (especially in diffuse lesions and on long-term follow-up), making this option safer in focal adenomyomas. Vannuccini S, Luisi S, Tosti C, Sorbi F, Petraglia F. Role of medical therapy in the management of uterine adenomyosis. The SF-36 was used to gather self-reported data on patients postoperative QOL in the short and long terms to investigate whether laparoscopic surgery is truly a minimally invasive procedure that meaningfully improves QOL. Study flowchart. Sharara FI, Kheil MH, Feki A, Rahman S, Klebanoff JS, Ayoubi JM, Moawad GN. In an attempt to fill this gap in knowledge, the Quality of Life after Embolization vs Hysterectomy in Adenomyosis (QUESTA) trial was set up. Hysterectomy is established as the final treatment option when conservative treatment fails. Important factors to be included in classification systems would be the site and location of pathology, configuration, and size/volume relative to the total myometrial thickness [31]. Uterine artery embolisation: fertility, adenomyosis and size - what is the evidence? Patients with written informed consents were randomly allocated (in a 2:1 ratio) between both experimental intervention (UAE) and standard care control groups (hysterectomy), while patients refusing randomization are given the standard of care (hysterectomy) [101]. d Diffuse asymmetric widening of the posterior myometrial wall with hyperechoic nodules(four arrows), Direct and indirect imaging features of adenomyosis. Three outcome parameters were measured. NM supervised the project. Diagn Interv Imaging. Cardiovasc Intervent Radiol. In this context, Andersen et al. Firouznia K, Ghanaati H, Sanaati M, Jalali AH, Shakiba M. Pregnancy after uterine artery embolization for symptomatic fibroids: a series of 15 pregnancies. RD contributed to the manuscript preparation and revision. Transvaginal sonographic criteria for the diagnosis of adenomyosis based on histopathologic correlation. Hysteroscopic resection/ablation is a combined treatment method involving the dissection and or coagulation of cystic adenomyotic lesions and crypts [7882]. Part of Du H, Taylor HS. The technique for UAE in adenomyosis is similar to that used in fibroids. Uterine artery embolization is an established treatment option for uterine fibroids and has recently gained ground as a safe and cost-effective method for treatment of uterine adenomyosis with. Nevertheless, paucity of literature comparing HIFU to other minimally invasive treatment options, limited availability, overall cost, unknown fertility outcomes, and strict indications, including lesions no more than 10cm in diameter [88, 90], no pelvic adhesions [84, 89, 90, 93], body weight less than 100kg [98], and abdominal wall thickness less than 5cm [93] may limit its widespread use. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. statement and Taran FA, Weaver AL, Coddington CC, Stewart EA. It has started since November 2015, and its primary outcomes are expected by May 2020 [101]. Efficacy of laparoscopic adenomyomectomy using double-flap method for diffuse uterine adenomyosis. and transmitted securely. 2023 BioMed Central Ltd unless otherwise stated. Resnick NJ, Kim E, Patel RS, Lookstein RA, Nowakowski FS, Fischman AM. 8600 Rockville Pike AH and LH cases are shown in Table 1, and the surgical outcomes are shown in Table 2. Van den Bosch T, de Bruijn AM, de Leeuw RA et al (2018) A sonographic classification and reporting system for diagnosing adenomyosis. GMS Interdiscip Plast Reconstr Surg DGPW. [11] reported that postoperative management using the enhanced recovery after surgery (ERAS) protocol after obstetrics and gynecology surgery increased the rate of postoperative patient recovery, increased patient satisfaction, and reduced postoperative hospital stay. Epub 2016 Jul 5. PubMedGoogle Scholar. J Clin Epidemiol. Giana M, Montella F, Surico D, Vigone A, Bozzola C, Ruspa G. Large intramyometrial cystic adenomyosis: a hysteroscopic approach with bipolar resectoscope: case report. Azziz R. Adenomyosis: current perspectives. Management of uterine adenomyosis: current trends and uterine artery embolization as a potential alternative to hysterectomy. Bazot M, Dara E. Role of transvaginal sonography and magnetic resonance imaging in the diagnosis of uterine adenomyosis. This consequently results in a management dilemma, particularly in symptomatic patients who wish to preserve their uterus [18]. High-intensity focused ultrasound (HIFU) is the use of intense ultrasound energy directly targeting abnormal tissues and their vascularity through heating and cavitation, sparing the normal surrounding tissues. Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan, Yasushi Kotani,Kosuke Murakami,Risa Fujishima,Akiko Kanto,Hisamitsu Takaya,Masao Shimaoka,Hidekatsu Nakai&Noriomi Matsumura, You can also search for this author in Also, newer drugs, such as aromatase inhibitors, have been investigated by Badawy et al. Naftalin J, Hoo W, Nunes N, Holland T, Mavrelos D, Jurkovic D. Association between ultrasound features of adenomyosis and severity of menstrual pain. Health condition Adenomyosis is defined as the benign invasion of endometrial stroma and glands in the myometrium, surrounded by hypertrophic and hyperplastic myometrium. Kim KA, Yoon SW, Lee C, et al. In addition, no special protocol, such as ERAS, was used for postoperative management, and the results were based on standard postoperative management. Symptomatic patients varyingly present with menorrhagia, dysmenorrhea, chronic pelvic pain, dyspareunia, and subfertility [3234], and up to 30% of patients are asymptomatic [34]. Obstet Gynecol Clin North Am. [Change in health-related quality of life and change in clinical symptoms after uterine artery embolization in patients with symptomatic adenomyosis uteri - evaluation using a standardized questionnaire] UAE to treat symptomatic adenomyosis uteri can significantly improve the health-related quality of life and clinical symptoms. https://doi.org/10.1186/s12905-021-01364-8, DOI: https://doi.org/10.1186/s12905-021-01364-8. Conservative surgical treatments aim to remove adenomyosis and preserve the remaining normal uterine muscles through laparotomy, laparoscopy, hysteroscopy, or combined approach. On the other hand, Kindai University Hospital treats approximately all total hysterectomies for uterine fibroids and adenomyosis via LH. Here, the general health scores were significantly higher for LH through 6months, whereas the mental health and vitality scores showed no significant differences at any time-point. Provided by the Springer Nature SharedIt content-sharing initiative. Quality of life after total laparoscopic hysterectomy versus total abdominal hysterectomy for stage I endometrial cancer (LACE): a randomised trial. National Library of Medicine At the time of submission of this article, data cleaning and analyses have not yet started. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Safety and efficacy of high intensity focused ultrasound ablation therapy for adenomyosis. In conclusion, lack of information is the main hurdle to overcome the complexity in management of adenomyosis. Feasibility of MRI-guided high intensity focused ultrasound treatment for adenomyosis. Surgical approach to hysterectomy for benign gynaecological disease. CAS Badawy AM, Elnashar AM, Mosbah AA. Zullo et al. Fujishita A, Masuzaki H, Khan KN, Kitajima M, Ishimaru T. Modified reduction surgery for adenomyosis. Further studies need to evaluate the impact of UAE on fertility and pregnancy rates in females with adenomyosis and the use of Levonorgestrel intrauterine device (LNG-IUD) to prevent recurrent disease . 1. Regardless of etiology, histopathologic features remain the same, and definitive diagnosis is established by the presence of ectopic, non-neoplastic, endometrial glands and stroma surrounded by hypertrophic and hyperplastic myometrium on hysterectomy specimens [1]. Coronal (a) and sagittal (b) T2W 1.5-T pelvic MRI images of a 42-year-old female with persistent pelvic pain following cesarean section show focal thickening of the posterior uterine wall transitional zone (asterisk) with tiny myometrial cyst (solidarrow head), suggesting focal adenomyosis. doi: 10.1016/j.ajog.2016.06.051. Peric H, Fraser IS. J Ultrasound Med 10.1002/jum.14638 [, Xiao-Ying Z, Ying-Shu G, Jiu-Mei C et al (2018) Effect of pre-treatment with gonadotropin-releasing hormone analogue GnRH- on high-intensity focussed ultrasound ablation for diffuse adenomyosis: a preliminary study. government site. Rates of menorrhagia, dysmenorrhea, and uterine volume reduction varied widely from 12.4 to 44.8%, 25 to 100%, and 12.7 to 54% respectively, increasing gradually overtime (from 1 to 24months). The results demonstrate that QOL is increased with laparoscopy in the short postoperative term, improves thereafter in both procedures, and shows no inter-group differences in the long term. In addition, the SF-36 used in our study did not include items related to the duration of return to a normal sex life, a metric of importance from the perspective of QOL after hysterectomy. The https:// ensures that you are connecting to the Cheung VYT. Keung JJ, Spies JB, Caridi TM. Short-term QOL for laparoscopy was significantly superior, but this difference disappeared after 6months and later for most of the items [9]. Exclusion criteria comprised those who had underwent LH or AH when preoperative MRI suspected malignancy or written consent could not be obtained. 1989 Mar;16(1):22135. Medical treatment is the first-line treatment option for adenomyosis aiming to relieve symptoms and maintain fertility with the least possible side effect. The evaluation of uterine artery embolization as a nonsurgical treatment option for adenomyosis. Results Twenty-nine patients with adenomyosis (15 with fibroids) were treated with UAE between September 2006 and January 2010.
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