Cystic adenomyoma surgery

Abstract

Objective: Cystic adenomyoma is a lesion located within the myometrium. It is lined with endometrium and has hemorrhagic content. This rare entity has been described as a focal form of adenomyosis. However, it is poorly understood, and the management of symptomatic patients is not codified. Our objective is to evaluate the effectiveness of treatment with planned surgery for cystic adenomyoma on symptoms and fertility in a retrospective series of patients.

Study design: This is a retrospective study between January 2011 and January 2018 in a university hospital of patients that had surgery for cystic adenomyoma with uterine preservation.

Results: Pre-operative, per-operative, and post-operative data were recorded. Of the 18 patients included, 3 were lost to follow-up; 15 underwent laparoscopic surgery and 3 operative hysteroscopies. Complications during and after surgery were rare, involving only 3 patients, and of low severity. One patient saw no improvement in pain after surgery and 2 patients saw only partial improvement in their pain; 7 patients achieved at least one pregnancy with favorable outcome after surgery.

Conclusion: Based on this series, we argue that conservative surgical treatment for cystic adenomyoma generally improves pain and fertility without causing morbidity.

Keywords: Adenomyoma; Adenomyosis; Endometriosis; Hysteroscopy; Surgery.