Combination of microwave endometrial ablation and postoperative dienogest administration is effective for treating symptomatic adenomyosis

Journal of Obstetrics and Gynaecology Research - Tập 44 Số 9 - Trang 1787-1792 - 2018
Kuniaki Ota1,2, Toshifumi Takahashi2, Satoru Shiraishi1, Hideki Mizunuma2
1Department of Obstetrics and Gynecology, Nasu Red Cross Hospital, Tochigi, Japan
2Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan

Tóm tắt

AbstractAimMenorrhagia and dysmenorrhea are common symptoms. Uterine adenomyosis is one of the causes of menorrhagia and dysmenorrhea. These symptoms often decrease the quality of life in women. Microwave endometrial ablation (MEA) is a recently developed procedure that enables endometrial ablation. Dienogest has long been used to suppress endometrium development and reduce adenomyosis‐related dysmenorrhea. However, some cases could be resistant to dienogest. In this study, we evaluated the efficacy of a combination of MEA and postoperative dienogest in reducing adenomyosis‐related dysmenorrhea and menorrhagia.MethodsTen patients with hormone treatment‐resistant symptomatic adenomyosis underwent MEA and were administered oral dienogest after the procedure. The primary endpoints were reduction in pain recurrence and anemia. The secondary endpoint was a change in the adenomyosis lesion and its symptomatic recurrence.ResultsStatistically significant improvements were seen in the visual analog scale score and hemoglobin levels in women post‐treatment. The difference in myometrial thickness pre‐ and post‐MEA was statistically significant. There were no cases of symptomatic recurrence.ConclusionThe combination of MEA and postoperative dienogest is useful for treating uterine adenomyosis with menorrhagia and dysmenorrhea.

Từ khóa


Tài liệu tham khảo

10.1007/s00404-009-0982-7

10.1111/j.1471-0528.1994.tb13689.x

10.1016/S0140-6736(95)91689-X

10.1111/j.1471-0528.1999.tb08368.x

10.1111/jog.12163

10.1111/jog.12787

Kohler G, 1987, Therapy of endometriosis with dienogest, Zentralbl Gynakol, 109, 795

10.5468/ogs.2016.59.6.506

10.1111/aogs.12633

10.3109/09513590.2016.1147547

10.1111/jog.13406

10.1111/jog.12811

KanaokaY IshikawaN AsakawaY NakayamaK. Practice Guideline of MEA. 2012. [Cited 1 April 2012]. Available from URL:http://www.alfresa-pharma.co.jp/microtaze/MEAguideline2012.pdf

Zheng J, 2013, Comparison of combined transcervical resection of the endometrium and levonorgestrel‐containing intrauterine system treatment versus levonorgestrel‐containing intrauterine system treatment alone in women with adenomyosis: A prospective clinical trial, J Reprod Med, 58, 285

10.1016/S1074-3804(05)60158-2

10.1016/j.contraception.2007.05.091

10.1111/jog.12030

Nakamura K, 2017, Long‐term outcomes of microwave endometrial ablation for treatment of patients with menorrhagia: A retrospective cohort study, Oncol Lett, 14, 7783

10.1016/j.steroids.2007.10.003

Ota Y, 2015, Long‐term administration of dienogest reduces recurrence after excision of endometroma, J Endometr Pelvic Pain Disord, 7, 63

10.1093/humrep/deq332

10.1093/humrep/det457

Thông tin
Thông tin xuất bản

Journal of Obstetrics and Gynaecology Research

Tập 44 Số 9

1787-1792

Thông tin tác giả