الانتباذ الغدي الرحمي: الإدارة عند عدم تحقيق علاج ناهض GnRH السيطرة الكافية على الأعراض

DOI: 10.1016/j.jogc.2023.04.008

• Uterine artery embolization is an effective treatment option for heavy bleeding and pain associated with adenomyosis; it can be offered to patients who have completed child-bearing and would like to preserve their uterus (strong, moderate).
• Endometrial ablation (EA) is a minimally invasive option that has a faster recovery and lower rate of serious complications than hysterectomy.
• Adenomyomectomy is an effective treatment option for symptomatic adenomyosis (strong, moderate).
• Given the substantial risk of intraoperative hemorrhage, anemia (hemoglobin <120 g/L) should be corrected before adenomyomectomy (strong, low).
• Given the potential for significant operative blood loss, anemia (hemoglobin <120 g/L) must be corrected preoperatively (i.e., with preoperative menstrual suppression and iron supplementation) to reduce morbidity and mortality.
• Total hysterectomy is an effective treatment option for symptomatic adenomyosis and can be offered to women who have completed child-bearing after appropriate counselling regarding risks, benefits, and alternative treatments (strong, low).