Weihong Yang1, Mingmin Liu1, Li Liu1, Caixia Jiang2, Li Chen2, Xiaoyan Qu1, Zhongping Cheng3. 1. Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China; Institute of Gynecologic Minimally Invasive Medicine, Tongji University School of Medicine, Shanghai, China. 2. Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China. 3. Department of Obstetrics and Gynecology, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China; Institute of Gynecologic Minimally Invasive Medicine, Tongji University School of Medicine, Shanghai, China. Electronic address: mdcheng18@263.net.
Abstract
STUDY OBJECTIVE: To evaluate safety, feasibility, and long-term clinical effects of adding laparoscopic pelvic plexus ablation to uterine-sparing procedures (uterine artery occlusion and partial adenomyomectomy) for adenomyosis. DESIGN: A prospective controlled study (Canadian Task Force classification II-1). SETTING: A teaching hospital. PATIENTS: A total of 112 patients with symptomatic adenomyosis were eligible for uterine-sparing laparoscopy. INTERVENTIONS: Laparoscopic pelvic plexus ablation, uterine artery occlusion, and partial adenomyomectomy. MEASUREMENTS AND MAIN RESULTS: After the exclusion of patients with malignant tumors or those lost to follow-up, 102 women underwent laparoscopic uterine artery occlusion and partial adenomyomectomy; 50 of these patients also had laparoscopic uterine pelvic plexus ablation (group A) with the remaining 52 patients serving as the control group (group B). Other than operative time (107.0 ± 15.4 vs 98.9 ± 20.2 minutes, p = .02), there were no statistical differences regarding other operative parameters between groups A and B. Relief of severe dysmenorrhea (Visual Analogue Scale score ≥ 7) at 36 months was higher in group A than in group B (100% vs 76.9%, p < .01). No patient suffered constipation or uroschesis in either group. CONCLUSION: Adding laparoscopic uterine pelvic plexus ablation to laparoscopic uterine artery occlusion and partial adenomyomectomy was more effective in relieving dysmenorrhea.
STUDY OBJECTIVE: To evaluate safety, feasibility, and long-term clinical effects of adding laparoscopic pelvic plexus ablation to uterine-sparing procedures (uterine artery occlusion and partial adenomyomectomy) for adenomyosis. DESIGN: A prospective controlled study (Canadian Task Force classification II-1). SETTING: A teaching hospital. PATIENTS: A total of 112 patients with symptomatic adenomyosis were eligible for uterine-sparing laparoscopy. INTERVENTIONS: Laparoscopic pelvic plexus ablation, uterine artery occlusion, and partial adenomyomectomy. MEASUREMENTS AND MAIN RESULTS: After the exclusion of patients with malignant tumors or those lost to follow-up, 102 women underwent laparoscopic uterine artery occlusion and partial adenomyomectomy; 50 of these patients also had laparoscopic uterine pelvic plexus ablation (group A) with the remaining 52 patients serving as the control group (group B). Other than operative time (107.0 ± 15.4 vs 98.9 ± 20.2 minutes, p = .02), there were no statistical differences regarding other operative parameters between groups A and B. Relief of severe dysmenorrhea (Visual Analogue Scale score ≥ 7) at 36 months was higher in group A than in group B (100% vs 76.9%, p < .01). No patient suffered constipation or uroschesis in either group. CONCLUSION: Adding laparoscopic uterine pelvic plexus ablation to laparoscopic uterine artery occlusion and partial adenomyomectomy was more effective in relieving dysmenorrhea.