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For Adenomyosis, Do You Actually Need Surgery?

Adenomyosis is a diffuse or localized lesion of the endometrial glands and interstitial invasion of the myometrium. Like Endometriosis, it is a common gynecological disease and a difficult disease. 

 

Adenomyosis occurs mostly in women between the ages of 30 and 50, but can also be seen in young women who have not given birth. Treatment can be drugs and others, and surgical treatment is also feasible. However, the choice of surgical treatment plan needs to be individualized in combination with the patient's age, symptoms and fertility requirements.

 

Surgical treatment includes radical surgery and conservative surgery. Radical surgery is hysterectomy, conservative surgery includes adenomyosis (adenomas) resection, endometrial and myometrial resection, myometrial coagulation, uterine artery occlusion, anterior tibial nerve resection, sacral nerve resection and so on. Feel free to refer to Oxford Academic Analysis for more details: https://academic.oup.com/humupd/article/4/4/323/610437

 

1. Hysterectomy

Applicable to patients without fertility requirements, and the lesions are extensive, the symptoms are serious, and conservative treatment is ineffective. Moreover, in order to avoid residual lesions, total hysterectomy is preferred, and partial hysterectomy is generally not advocated.

 

2. Adenomyosis lesion resection

Suitable for patients with fertility requirements or younger. Factor uterine adenomyosis is often diffuse and unclear with normal uterine muscle tissue, so how to choose the method of resection to reduce bleeding, residual and facilitate postoperative pregnancy is a more difficult problem.

 

3. Interventional therapy

Selective uterine artery embolization can also be used as one of the treatments for adenomyosis. Its mechanism of action works on: ectopic endometrial necrosis,and reduction of prostaglandins secretion, it relieves dysmenorrhea, and reduce menstrual flow as well as recurrence rate; establishment of collateral circulation in the lining layer, the basal layer can gradually migrate growth and restore function.

 

However, uterine artery embolization affects the blood supply of the uterus and ovaries, which has an adverse effect on pregnancy. It may cause infertility, miscarriage, premature birth and increase cesarean section rate.

 

Thus, in addition to hysterectomy, other surgical procedures is not effective to cure adenomyosis while causing trauma. However, hysterectomy can lead to sterilization, and patients should be careful.

 

On a second thought, for patients who have fertility requirements and do not want surgery, orally take TCM formula Fuyan Pill can be a good choice. Of all the ingredients, heat-clearing and detoxifying drugs are compatible with blood-activating drugs, softening and unblocking blood stasis, eliminating lumps, and regulating menstruation. Generally three courses will get the patient cured safely, effectively, and painlessly.

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