Page 93 - ESHRE2019

Uterus sparing surgical treatment of adenomyosis
 Complete resection is nearly impossible
 Uterine cavity frequently opened
 Uterine defect more difficult to repair
 Uterinescarsnot returningtonormal tensile
increased risk uterine rupture, pelvic adhesions, intra- uterine adhesions, deformation uterine cavity, reduced ut erine capacit y
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Hisao Osada Uterine adenomyosis and adenomyoma: the surgical approach Fertil Steril 2018; 109: 3: 406-417
Conclusion:
Focal adenomyosis lesion treat laparoscopically.
Diffuse adenomyosispreferably be treated by laparotomy or preferably by laparoscopically-assisted laparotomy.
Open surgery is safer than laparoscopy in that it can thoroughly excisethelesionstoprevent therecurrenceandtoproperly Reconstruct the defect created by the surgery in order to prevent uterine rupture due to subsequent pregnancy
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PRECONGRESS COURSE 11 I VIENNA, AUSTRIA – 23 JUNE 2019 91