Management of uterine adenomyosis: current trends and uterine artery embolization as a potential alternative to hysterectomy

Dessouky, Riham; Gamil, Sherif A.; Nada, Mohamad Gamal; Mousa, Rola; Libda, Yasmine

doi:10.1186/s13244-019-0732-8

Cited by 59 publications

(62 citation statements)

References 107 publications

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“…Classical surgical management of adenomyosis, including laparoscopic adenomyosis lesion excision, is associated with a high uterine rupture risk and relatively long recovery time [27]. Although hysterectomy is considered the most effective approach to cure adenomyosis, it is not suitable for patients who have the desire to give birth [28]. HIFU as a noninvasive treatment has been shown to improve the pregnancy outcomes of patients with adenomyosis [29].…”

Section: Discussionmentioning

confidence: 99%

A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision

Huang

Deng

Wei

et al. 2020

International Journal of Hyperthermia

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2020) A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision, International ABSTRACT Objective: The aim of this study was to compare the treatment effects of high-intensity focused ultrasound (HIFU) and laparoscopic excision (LE) in patients with adenomyosis and infertility. Materials and methods: A total of 93 patients with adenomyosis and infertility who were treated with HIFU (50 patients) or LE (43 patients) from January 2012 to January 2017 at the Third Xiangya Hospital of Central South University were retrospectively analyzed. Clinical characteristics including dysmenorrhea severity pain score, menorrhagia severity scores, reproductive outcomes, complications during pregnancy and delivery, adverse effects, surgical complications, and other clinical variables were compared between the HIFU and LE groups. Results: Of the total 93 patients with adenomyosis and infertility, 50 were treated with HIFU and 43 underwent LE. Both HIFU and LE treatments achieved significant relief of dysmenorrhea and menorrhagia. The total hospital stay was shorter in patients treated with HIFU than in those who underwent LE surgery. Neither HIFU nor LE treatment led to severe complications after treatment. Most importantly, patients treated with HIFU showed significantly higher pregnancy rates and natural conception rates than those who underwent LE surgery. Notably, in the HIFU treatment group, those with diffuse adenomyotic lesions had significantly lower postoperative pregnancy rates than those with focal adenomyosis. Conclusion: HIFU showed a safe and effective profile as a therapeutic management option for patients with adenomyosis. In comparison with LE, HIFU treatment achieved better postoperative reproductive outcomes. HIFU treatment should be encouraged and implemented in clinical practice. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision

Huang

Deng

Wei

et al. 2020

International Journal of Hyperthermia

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“…Adenomyosis is defined as the presence of benign endometrial glands and stroma in the myometrium [30]. However, there is no agreement on the classification of adenomyotic lesions from both the histopathological and the imaging point of view [31].…”

Section: Thinning Of Ujz Thickness After Treatment With Mirenamentioning

confidence: 99%

Studies on a Levonorgestrel-Releasing Trade Plastic Device and on a Similar Polyurethane Foam Used as a Levonorgestrel Carrier

Olaru¹,

Stoian²,

Vaduva³

et al. 2019

Mat.Plast.

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Hormonal Intrauterine Devices (IUD) were developed based on copper IUD with the role to release a daily amount of hormones. From a structural point of view Levonorgestrel-IUD (L-IUD) is a small T-shaped piece of plastic, which contains levonorgestrel. When compared with the oral route of L-IUD administration, it provides some advantages because it releases levonorgestrel directly into the uterus. Our aims were: (1) to compare the thickness of uterine jonctional zone (UJZ) in two groups of patients with and without inserted L-IUD, (2) to evaluate the changes in thickness of UJZ after the insertion of L-IUD in two patients with adenomyosis, and (3) to obtain and to characterize a similar T-shaped polyurethane (PU) foam used as a levonorgestrel delivery system. On the one hand, the results confirm that L-IUD is effective in thinning the UJZ and in the treatment of adenomyosis, while on the other hand, the characterization of the PU materials (Zetasizer measurements, their thermal degradation, UV-Vis spectra and skin irritation tests) revealed that this polymer can be used as a safety and prolonged levonorgestrel carrier.

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“…Adenomyosis patients are usually treated with anti‐inflammatory drugs, hormones, and hysterectomy 4 . However, hysterectomy, which cannot be accepted by all patients, is still the only cure for adenomyosis 5 . At present, the molecular mechanisms of adenomyosis are barely known, which limits the development of novel therapeutic approaches for adenomyosis 6 …”

Section: Introductionmentioning

confidence: 99%

LncRNA MIR22HG is downregulated in adenomyosis and upregulates miR‐2861 through demethylation to inhibit endometrial cell proliferation

Cui

Xue

2021

J of Obstet and Gynaecol

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Aim Endometrial cell proliferation plays a critical role in adenomyosis. It has been reported that MIR22HG and miR‐2861 play similar roles in regulating endometrial cell proliferation, indicating their involvement in adenomyosis. This study aimed to investigate the potential involvement of MIR22HG and miR‐2861 in adenomyosis. Methods Endometrial biopsy was collected from both adenomyosis (n = 45) and the healthy controls (n = 45). The expression of MIR22HG and miR‐2861 in biopsies were determined by quantitative reverse transcription polymerase chain reaction (RT‐qPCR). The relationship between MIR22HG and miR‐2861 in endometrial cells was analyzed by RT‐qPCR. Methylation‐specific PCR (MSP) was performed to analyze the effects of overexpression of MIR22HG on the expression of miR‐2861. Western‐blot assays were performed to illustrate the effect of MIR22HG, miR‐2861, STAT3, and MMP2 on adenomyosis. Luciferase report assay was performed to analyze the interactions among miR‐2861, STAT3, and MMP2. The role of MIR22HG and miR‐2861 in regulating the proliferation of endometrial cells was analyzed by cell proliferation assay. Results The expression of MIR22HG and miR‐2861 in adenomyosis did not change with menstrual cycle. MIR22HG and miR‐2861 were significantly downregulated in adenomyosis and they were significantly and positively correlated with each other. In endometrial cells, overexpression of MIR22HG upregulated the expression of miR‐2861 and decreased methylation of miR‐2861 gene. MIR22HG and miR‐2861 downregulated STAT3 and MMP2 to inhibit the proliferation of endometrial cells. In addition, overexpression of both MIR22HG and miR‐2861 showed stronger effects. Conclusion MIR22HG is downregulated in adenomyosis and upregulates miR‐2861 through demethylation to inhibit endometrial cell proliferation.

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Management of uterine adenomyosis: current trends and uterine artery embolization as a potential alternative to hysterectomy

Cited by 59 publications

References 107 publications

A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision

A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision

Studies on a Levonorgestrel-Releasing Trade Plastic Device and on a Similar Polyurethane Foam Used as a Levonorgestrel Carrier

LncRNA MIR22HG is downregulated in adenomyosis and upregulates miR‐2861 through demethylation to inhibit endometrial cell proliferation

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