Application of central uterine body ectomy combined with gonadotrophin releasing hormone agonist under laparoscope on the treatment of adenomyosis

Abstract:

Objective：To investigate the clinical curative effect of central uterine body ectomy combined with gonadotropin releasing hormone agonist（GnRH-a） under laparoscope on the treatment of adenomyosis. Methods：From January 2015 to December 2017，35 patients with adenomyosis who chose central uterine body ectomy under laparoscope in our hospital were selected as the study group and were treated with GnRH-a（zoladex） for 6 months after operation，and 35 patients with adenomyosis chose to laparoscopic hys－terectomy were taken as the control group. Patients in the two groups were followed up for 6-12 months；the operation time，intraoper－ative blood loss，the recovery time of gastrointestinal function after operation，dysmenorrhea improvement，the quality of sexual life after operation，perimenopausal symptoms as well as relative sexual hormone levels and postoperative satisfaction degree were com－pared between two groups. Results：The operation time in the study group was longer than that in the control group，the intraoperative blood loss was more than that in the control group，with statisti－cally significant difference（P=0.000）. There was no significant difference in the recovery time of gastrointestinal function be－tween two groups（P=0.874）. The dysmenorrhea in two groups after operation were significantly less than that before opera－tion，with statistically significant difference（P=0.000）. The quality of sexual life in the study group was higher than that in the control group（P=0.000）. Level of estradiol（E2） and follicle-stimulating hormone（FSH） before operation and one year after operation in the study group had no significant difference（P=0.076，P=0.253）. In the control group，the level of E2 one year after operation was lower than that before operation，and the level of FSH was higher than that before operation（P=0.002）. The postoperative satisfaction in the study group was significantly higher than that in the control group（P=0.000）. Conclusion：Central uterine body ectomy combined with zoladex under laparoscope on the treatment of adenomyosis can improve the clinical symptom，meet patients’ desire to retain the uterus and avoid adverse effects of total hysterectomy，after which patients enjoys a better recovery and satisfaction，and is a preferable choice for patients with adenomyosis who need to retain the uterus.