Modified reduction surgery for adenomyosis. A preliminary report of the transverse H incision technique.

We describe the preliminary clinical results of a modified method of reduction surgery for easy approach and effective removal of lesions in women with adenomyosis. Old classical reduction surgery was performed in 5 women with imaging diagnosis of adenomyosis who were selected retrospectively among 104 patients undergoing conservative surgery. A transverse H incision method in the reduction surgery was applied to 6 of 83 patients wishing to preserve fertility. Benefit in operative procedure, complications, patients' compliance, and pregnancy outcome were analyzed and compared between 5 women with the classical method and 6 women with the H incision method for adenomyosis. No apparent difference was observed in the operation time, blood loss and volume of excised specimens between these two groups. The major complication of perforation during surgery occurred in 2 patients (40%) by the classical method and in only 1 patient (17%) by the H incision technique. The subjective relief of pain was relatively more evident in the modified than in the classical group. There was no case of pregnancy in the classical group; however, 1 patient conceived spontaneously 4 months after operation by this H incision procedure. Our H incision technique may be considered a useful method for an easy surgical approach and satisfactory removal of adenomyotic lesions and may be better than the old classical method of reduction surgery. Copyright 2004 S. Karger AG, Basel