2.3. Adenomyomectomy procedure
bleeding, cancer, dysmenorrhea, adenomyosis, menorrhagia
BLEEDING, CANCER, DYSMENORRHEA, ADENOMYOSIS, REMISSION, MENORRHAGIA, COMPLICATIONS
We designed a novel operative procedure consisting of the following methods. First, an initial measurement of the adenomyotic lesion was made using ultrasonography and MRI (Fig. Schematic (a–e) and actual images (f–j) of the adenomyomectomy procedure. (a & f) A T-shaped incision is made on the uterine wall. (b & g) The serosal flap exposes adenomyotic tissue. (c & h) The adenomyotic tissue is shaved using the Argon laser. (d & i) The border between the serosal flap and residual myometrium is sutured. (e & j) The serosal flap is closed and fixed to the underlying myometrium via fixation suture.The adenomyotic region was wide and lacked clear boundaries; hence, an argon laser (ValleylabAs illustrated in Figure After adenomyomectomy, the weight of the resected adenomyotic tissue, time of operation, amount of bleeding, and complications were recorded. Before and after the reductive operation, all patients received 3 cycles of GnRHa therapy, and their serum cancer antigen 125 (CA125) levels were measured. Symptom relief of menorrhagia and dysmenorrhea were evaluated by pictogram and by NRS, respectively. MRI and ultrasonography were used to confirm the remission of adenomyosis.