Organ-sparing surgery for adenomyosis
- Authors: Rukhliada N.N.1,2, Krylov K.Y.1, Biryukova E.I.2
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Affiliations:
- Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia
- I.I. Dzhanelidze Saint Petersburg Research Institute of Emergence Care
- Issue: No 5 (2019)
- Pages: 86-89
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/248506
- DOI: https://doi.org/10.18565/aig.2019.5.86-89
- ID: 248506
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Open Access
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Abstract
Objective. To analyze the results of organ-sparing treatment in women with adenomyosis. Material and methods. Since 2003, a total of 203 adenomyomectomies, with the initial uterus sizes being at 9 to 22 weeks’ gestation, have been performed. A number of interventions were made according to the original procedure, when on one side, the myometrial flap is rolled and stitched to the bottom of the formed niche, and the second flap completely covers the defect, blocking it repeatedly. Thus, at least 4-5 myometrial layers rather than 1-2 ones are formed above the uterine cavity. Results. Pain syndrome was eliminated in 15% of women; at 3 months after surgery, 74% of women showed a significant decrease in the intensity of pain from 8.2±2.4 to 3.2±2.2 scores (p < 0.001); in 11% of patients, the operation did not led to a reduction in the severity of pain (p < 0.001). In the follow-up period of up to 12 months after surgery, the hemoglobin concentration was noted to normalize in 84% of cases in the absence of pregnancy. Pregnancy occurred in 39 (47.6% or 19.2% of all interventions) out of 82 women who were interested in fertility restoration. Conclusion. The elimination of bleeding and anemia in 84% and a significant reduction in pain syndrome in 74% of the operated patients lead to the conclusions that quality of life is improved in patients with adenomyosis after adenomyomectomy.
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About the authors
Nikolai N. Rukhliada
Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia; I.I. Dzhanelidze Saint Petersburg Research Institute of Emergence Care
Email: nickolasr@mail.ru
MD, professor, chief researcher of the Department of Gynecology; head of the Department of Obstetrics and Gynecology with a course of pediatric gynecology, chief specialist
Kirill Yu. Krylov
Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia
Email: drkrylov@mail.ru
researcher, obstetrician-genicologist
Elena I. Biryukova
I.I. Dzhanelidze Saint Petersburg Research Institute of Emergence Care
Email: 79112252131@yandex.ru
PhD, head of the Department of Gynecology №2
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