Massive uterine adenomyosis: A long-term followup of its conservative surgical treatment

Fifteen patients with massive diffuse adenomyosis underwent laparotomic uterine debulking. Retrospective analysis regarded menstrual characteristics, pelvic pain, dyspareunia and reproductive outcome. Statistical analysis was obtained using t test. P<0.05 was considered significant. Mean age was 34.6 years. Follow-up lasted a mean of 41.4 months. No intraoperative nor postoperative complications occurred. At 12 months after surgery, 13 patients (87%) reported complete resolution of menorrhagia, mean VAS for dysmenorrhea was 1.8 ± 2.48 and mean VAS for chronic pelvic pain was 1.0 ± 2.17. At 6 months after surgery all patients had normal hemoglobin levels. One patient had 2 spontaneously-conceived term pregnancies. Despite the low postoperative pregnancy rate obtained in this study, symptoms were significantly improved in terms of dysmenorrhea, menorrhagia and sideropenic anemia. The long-term follow-up shows persistence of the improvement in symptoms.