Comparison of surgery alone and combined surgical-medical treatment in the management of symptomatic uterine adenomyoma

Peng Hui Wang, Wei Min Liu, Jong Ling Fuh, Ming Huei Cheng, Hsiang Tai Chao

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68 Citations (Scopus)

Abstract

Objective: To compare the efficacy of surgical-medical treatment and surgery alone in the treatment of uterine symptomatic adenomyoma. Design: Prospective nonrandomized study. Setting: Medical centers. Patient(s): One hundred sixty-five women treated with conservative adenomyomectomy. Intervention(s): Surgery followed by six-course treatment (n = 114, surgical-medical group) or no treatment (n = 51, surgery-alone group) with a gonadotropin-releasing hormone (GnRH) agonist regimen. Main Outcome Measure(s): Symptom relief (scale: 0, no symptoms, to 5, worst symptoms) and relapse (when any one scale was ≥2 after treatment) during the 2-year follow-up period. Result(s): The general characteristics of the patients were similar in both groups, except for the diameter of the adenomyoma and age. Patients in both groups had statistically significant symptom relief, and all symptom scores declined from a mean of 3 or 4 to a mean of 1 or less at the end of the 2-year follow-up period. The symptom-relapse rates in the surgical-medical group were statistically significantly lower than those in the surgery alone group (n = 32, 28.1% vs. n = 25, 49.0%, respectively). Conclusion(s): Conservative surgery, regardless of GnRH agonist treatment, may be acceptable for management of a selected population with severe symptomatic adenomyoma. However, surgical-medical treatment provided more effective symptom control (a lower symptom relapse rate) than surgery alone during the 2-year follow-up period.

Original languageEnglish
Pages (from-to)876-885
Number of pages10
JournalFertility and Sterility
Volume92
Issue number3
DOIs
Publication statusPublished - Sep 2009

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Keywords

  • Adenomyoma
  • conservative surgery
  • gonadotropin-releasing hormone agonist
  • surgical-medical management

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

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