Modern approaches to performing organ-preserving operations in adenomyosis

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Abstract

The incidence of adenomyosis in young patients who have not realized their reproductive function is steadily increasing, with the tactics of surgical and drug treatment being an unresolved problem. In clinical practice, special attention is focused on the possibility of surgical treatment of adenomyosis with preservation of the uterus; and a variety of new options for such operations are proposed, as well as ways to optimize the treatment of such patients. This article summarizes our own and world experience in managing such patients. We present current views regarding the selection of patients for such interventions and determining the indications for surgery, and we herein highlight the technical features of such interventions. A particular attention is paid to management tactics being aimed at ensuring reproductive function implementation.

About the authors

Arsenii S. Molotkov

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Author for correspondence.
Email: arseny.molotkov@gmail.com
ORCID iD: 0000-0003-3433-3092
SPIN-code: 6359-6472
Scopus Author ID: 56058571100

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Maria I. Yarmolinskaya

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: m.yarmolinskaya@gmail.com
ORCID iD: 0000-0002-6551-4147
SPIN-code: 3686-3605
Scopus Author ID: 7801562649
ResearcherId: P-2183-2014

MD, Dr. Sci. (Med.), Professor, Professor of the Russian Academy of Sciences

Russian Federation, Saint Petersburg

Anna A. Tsypurdeeva

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: tsypurdeevan@mail.ru
ORCID iD: 0000-0001-7774-2094
SPIN-code: 5208-9707

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Maria A. Shalina

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: amarus@inbox.ru
ORCID iD: 0000-0002-5921-3217
SPIN-code: 6673-2660
Scopus Author ID: 57200072308
ResearcherId: A-7180-2019

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

References

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  7. Kuo HH, Weng CH, Jaiswal A, et al. Performing laparoscopic adenomyomectomy with the four-petal method. Fertil Steril. 2020;114(6):1352–1354. doi: 10.1016/j.fertnstert.2020.07.032
  8. Rossiyskoe obshchestvo akusherov-ginekologov (ROAG). Endometrioz. Klinicheskie rekomendatsii. 2020 [cited 2023 May 25]. Available from: https://roag-portal.ru/recommendations_gynecology
  9. Zhou Y, Shen L, Wang Y, et al. Long-term pregnancy outcomes of patients with diffuse adenomyosis after double-flap adenomyomectomy. J Clin Med. 2022;11(12). doi: 10.3390/jcm11123489
  10. Kwack JY, Lee SJ, Kwon YS. Pregnancy and delivery outcomes in the women who have received adenomyomectomy: Performed by a single surgeon by a uniform surgical technique. Taiwan J Obstet Gynecol. 2021;60(1):99–102. doi: 10.1016/j.tjog.2020.11.015

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Uterine cavity with adenomyosis foci

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3. Fig. 2. Uterus with adenomyosis

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4. Fig. 3. Removal of the adenomyosis node

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5. Fig. 4. Uterus after removal of the adenomyosis node and suturing

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