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Adenomyoma is a condition characterized by the presence of abnormal tissue growth (endometrial tissue) within the muscular wall of the uterus (myometrium). This condition can lead to symptoms such as pain, heavy menstrual bleeding, and fertility issues. It is divided into focal and diffuse.

 

When it is Performed

Adenomyoma surgery is performed when the condition causes significant symptoms and conservative treatments have not been effective in managing these issues.

Purpose of the Procedure

The primary purposes of adenomyoma surgery are:

Symptom Relief

To alleviate pelvic pain, heavy menstrual bleeding, and other symptoms associated with adenomyoma.

Preservation of Fertility

When it is focal adenomyosis.

Tissue Removal

To excise the abnormal tissue growth within the uterine wall.

What is expected to be performed

There are different surgical approaches to treat adenomyoma, including:

Laparoscopic Surgery

This minimally invasive procedure involves making small incisions in the abdomen and using a laparoscope to visualize and excise the adenomyoma or perform uterine-sparing procedures.

Open Surgery (Abdominal AdenoMyomectomy)

 In more extensive cases, an abdominal incision is made, and the adenomyoma is removed.

Anesthesia

General anesthesia is typically administered to ensure the patient is unconscious and pain-free during the procedure.

Incisions

The size and location of incisions depend on the surgical approach. Laparoscopic surgery involve small incisions, while abdominal adenomyomectomy requires a larger abdominal incision.

Surgical Instruments and Equipment

Surgical instruments may include laparoscopes, hysteroscopes, electrosurgical devices, scalpels, and specialized instruments for tissue removal.

Duration of Surgery

The length of surgery varies based on the extent of adenomyoma and the chosen surgical approach. Laparoscopic and hysteroscopic procedures are generally shorter than open surgery, which may take several hours.

Intraoperative Monitoring

Monitoring equipment, including ECG and blood pressure monitors, is used to ensure the patient's safety during surgery.

Potential Complications:

Potential complications of adenomyoma surgery may include:

  • Bleeding during or after surgery.
  • Infection at incision sites.
  • Injury to adjacent structures (rare).
  • Formation of adhesions (scar tissue).
  • Risk of recurrence (adenomyoma can return).

Expected Outcomes

Expected outcomes of adenomyoma surgery include:

  • Relief from pelvic pain and heavy menstrual bleeding.
  • Improvement in fertility for those with fertility issues.
  • Removal of abnormal tissue growth.

– Alternatives to Surgery

Alternatives to surgery may include medical management of symptoms with pain relievers, hormone therapy, or other conservative approaches. However, surgery is often necessary when symptoms are severe or fertility is a concern.

– Scarring

The extent and visibility of scarring depend on the type of surgery. Laparoscopic surgery typically result in smaller, noticeable scars, while abdominal myomectomy leaves a larger abdominal scar.

Post-operative Care:

Post-operative care includes:

  • Pain management.
  • Recovery instructions, including activity restrictions.
  • Follow-up appointments for monitoring and assessment.
  • Instructions for incision care and any prescribed medications.

– Hospital Stay

The duration of hospital stay depends on the surgical approach and individual factors. Laparoscopic and hysteroscopic procedures may allow for shorter hospital stays, while abdominal myomectomy may require a longer stay.

Recovery Time

Recovery time varies:

Immediate recovery

Patients may experience discomfort and fatigue.

Return to light activities

Usually within a few weeks.

Full recovery

Over several weeks to a few months, depending on the procedure and individual factors.

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