Optimal approaches in the diagnosis and treatment of adenomyosis

Abstract

Adenomyosis is a serious and debilitating disease that profoundly affects women's quality of life and reproductive function. Adenomyosis is one of the common benign diseases of the uterus, and patients may present with symptoms such as dysmenorrhea, dyspareunia, abnormal uterine bleeding (AUB), and infertility. Treatment can be medical and surgical. Hormonal drugs represent the first-line therapy of adenomyosis, and are highly effective in reducing symptoms and uterine volume. In cases where medi­cal therapy is ineffective, surgical treatment may be offered. In surgical treatment, hysterectomy remains the only definitive treatment available, but in recent decades, uterine-preserving surgical treatment has become more common. On the other hand, surgical-con­servative treatment of ade­nomyosis is very effective in reducing uterine volume while impro­ving abnormal uterine bleeding and pelvic pain. Because adenomyosis is often found together with other forms of endometriosis, cytoreductive surgery can be very complicated, therefore, it should be performed primarily by experienced surgeons in specialized centers.