Conservative surgical treatment combined with GnRH agonist in symptomatic uterine adenomyosis

ABSTRACT

To investigate the safety and therapeutic outcomes of conservative surgery combined with GnRH agonist for uterine adenomyosis. Eighteen women with symptomatic uterine adenomyosis were analyzed retrospectively at Cheil General Hospital and Women's Healthcare Center, Seoul, Korea, between March 2008 and November 2009. We used the mean numerical rating scale [MRS] for dysmenorrhea and the Mansfield-Voda-Jorgensen menstrual bleeding scale [MVJ] for menorrhagia before and after the treatment. The mean follow-up period was 9.7 months [6-16 months]. The mean surgical time was 92.5 min, the mean estimated blood loss was 238.9 ml, and the mean hospital stay after operation was 3.4 days. The mean decrease of hemoglobin was 2.0 g/dL After combination of surgery and GnRH agonist, the mean MRS of dysmenorrhea decreased significantly from 8.1 to 1.9 [P < 0.001], and the mean MVJ score also decreased from 4.3 to 3.2 [P < 0.05]. This conservative surgery should be considered as a therapeutic option for women with symptomatic adenomyosis who wish to preserve the uterus