Hysteroscopic diagnosis and excision of myometrial cystic adenomyosis.
Hysteroscopic diagnosis and excision of myometrial cystic adenomyosis.
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DOI：
10.1007/s10397-014-0861-5
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发表时间：
2014
影响因子：
--
通讯作者：
Brosens, I
中科院分区：
文献类型：
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作者：
Gordts, S;Campo, R;Brosens, I
1908 年，Cullen 在他的子宫腺肌瘤教科书中描述了第一例囊性子宫腺肌病。虽然这种情况并不常见，但随着磁共振成像 (MRI) 和 3-D 经阴道超声等无创成像技术的引入，报道的病例数量不断增加。患者主要抱怨严重痛经、慢性盆腔疼痛和功能失调性子宫出血。目前，尚不清楚子宫腺肌病，更具体地说，囊性子宫腺肌病是否可能是生育力和生殖结果受损的根本原因。随着生育的推迟，寻求生育治疗的子宫腺肌症和囊性子宫腺肌症患者越来越多。因此，对于这些患者，子宫探查不仅应包括子宫内膜腔的评估，还应包括子宫内膜下区的探查。间接成像技术与办公室微型宫腔镜检查相结合，提供了完整子宫探查的可能性。本文描述了两名囊性子宫腺肌病患者：一名以月经过多为主诉，另一名因不孕和严重痛经而转诊评估。这些病例报告的目的是提出宫腔镜解剖和子宫腺肌囊肿消融作为手术治疗这种情况的替代手术。
In 1908, Cullen described the first cases of cystic adenomyosis in his textbook on adenomyomata. Although not very common, with the introduction of noninvasive imaging techniques such as magnetic resonance imaging (MRI) and 3-D transvaginal ultrasound, an increasing number of cases have been reported. Patients primarily complain of severe dysmenorrhea, chronic pelvic pain, and dysfunctional uterine bleeding. Currently, it is unclear whether adenomyosis and, more specifically, cystic adenomyosis can be an underlying reason for impaired fertility and reproductive outcome. With the postponement of childbearing, the number of patients with adenomyosis and cystic adenomyosis seeking fertility treatment is increasing. Therefore, in these patients, uterine exploration should include not only the evaluation of the endometrial cavity but also the exploration of the sub-endometrial zone. Indirect imaging techniques, combined with office mini-hysteroscopy, offer the possibility of complete uterine exploration. Two patients with cystic adenomyosis are described in this paper: one had the chief complaint of menorrhagia and the other was referred for evaluation of infertility and severe dysmenorrhea. The aim of these case reports is to present hysteroscopic dissection and ablation of adenomyotic cysts as an alternative procedure for the surgical management of this condition.