Experience of uterus-sparing surgical treatment in diffuze (stages III-IV) adenomyosis

Background. The frequency of adenomyosis varies from 10 to 61%. Currently used methods of surgical treatment of adenomyosis are discussable. A hysterectomy it is not appropriate for women who wish to realize reproductive function or spare the uterus. Now it is very important to perform uterus-sparing surgery for treatment diffuse adenomyosis with severe manifestation of symptoms. Adenomyomecomy with hysteroplasty is modern method of surgical treatment for repair uterus anatomy and functions. Aim. To demonstrate methods of uterus-sparing surgical treatment in diffuse adenomyosis (stages III and IV). Materials and methods. In Surgical Department of Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology since January 2019 till June 2021 we performed 30 uterus-sparing adenomyomectomies with hysteroplasty in women with diffuse adenomyosis (stages III and IV). Results. There are some advantages of adenomyomectomies with hysteroplasty: it is possible to perform this method laparoscopically assisted; also special performing double-flaps recovery of myometrium (like a “frock coat”) allow to avoid uterine scar defects and uterine rapture during pregnancy. Conclusion. One of options of uterus-sparing surgical treatment for women with diffuse adenomyosis who wish to save their uterus and realize reproductive function is adenomyomectomy with hysteroplasty. Women who underwent this method notes pain relief and normalization of menstrual function and improvement life quality.

adenomyosis, metroplasty, surgery, uterus conserving surgery