Our Summary

This research paper discusses a study carried out in a teaching hospital that looked at whether adding a procedure called laparoscopic pelvic plexus ablation to other surgical procedures could help women with a condition called adenomyosis.

Adenomyosis is a condition where the tissue that normally lines the uterus grows into the muscular wall of the uterus. This can cause heavy or prolonged menstrual bleeding, severe cramping, and pain during intercourse. In this study, 112 women with adenomyosis were eligible for surgery that would spare their uterus.

The researchers divided the women into two groups. One group underwent two types of surgery - uterine artery occlusion and partial adenomyomectomy, while the other group underwent these two surgeries plus a third type called laparoscopic uterine pelvic plexus ablation.

The study found that adding the third surgery didn’t cause any significant changes in operative parameters, except for a slightly longer operation time. However, the group that had the third surgery had a higher rate of relief from severe menstrual pain 36 months after surgery. No patients suffered from constipation or inability to urinate after the surgery.

The researchers concluded that adding laparoscopic uterine pelvic plexus ablation to the other two surgeries was more effective in relieving menstrual pain in women with adenomyosis.

FAQs

  1. What is laparoscopic pelvic plexus ablation and how does it relate to adenomyosis treatment?
  2. What were the main findings of this study on the addition of laparoscopic pelvic plexus ablation to uterine-sparing procedures?
  3. Did the study find any significant side effects or complications from adding laparoscopic pelvic plexus ablation to uterine artery occlusion and partial adenomyomectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about uterine ablation is to expect relief from severe dysmenorrhea (painful periods) after the procedure. Adding laparoscopic pelvic plexus ablation to uterine-sparing procedures has been shown to be effective in relieving dysmenorrhea in patients with adenomyosis. This additional step can lead to long-term improvement in symptoms and overall quality of life.

Suitable For

Patients with symptomatic adenomyosis who have not responded to other forms of conservative treatment are typically recommended for uterine ablation procedures such as laparoscopic pelvic plexus ablation, uterine artery occlusion, and partial adenomyomectomy. These procedures are aimed at relieving symptoms such as severe dysmenorrhea and improving quality of life for patients with adenomyosis. It is important for patients to undergo a thorough evaluation and consultation with a healthcare provider to determine the most appropriate treatment plan for their individual case.

Timeline

  • Before uterine ablation:
  1. Patient experiences symptoms of adenomyosis such as severe dysmenorrhea.
  2. Patient undergoes evaluation and diagnosis of adenomyosis.
  3. Patient may undergo conservative treatments such as medication or hormonal therapy.
  4. Patient may consider uterine-sparing procedures such as laparoscopic uterine artery occlusion and partial adenomyomectomy.
  • After uterine ablation:
  1. Patient undergoes laparoscopic pelvic plexus ablation in addition to uterine artery occlusion and partial adenomyomectomy.
  2. Relief of severe dysmenorrhea is evaluated at 36 months post-procedure.
  3. Patients in the study group who received pelvic plexus ablation showed higher relief of dysmenorrhea compared to the control group.
  4. Patients in both groups did not experience constipation or uroschesis post-procedure.

What to Ask Your Doctor

  1. How does uterine ablation work to treat adenomyosis?
  2. What are the potential risks and complications associated with uterine ablation?
  3. What is the success rate of uterine ablation in relieving symptoms of adenomyosis?
  4. Are there any long-term effects or considerations to be aware of after undergoing uterine ablation?
  5. How does laparoscopic pelvic plexus ablation compare to other uterine-sparing procedures for adenomyosis?
  6. What is the recovery process like after undergoing uterine ablation?
  7. Are there any specific lifestyle changes or precautions I should take after the procedure?
  8. Will I still be able to have children after undergoing uterine ablation?
  9. How often will I need follow-up appointments after the procedure?
  10. Are there any alternative treatments or procedures I should consider for treating my adenomyosis?

Reference

Authors: Yang W, Liu M, Liu L, Jiang C, Chen L, Qu X, Cheng Z. Journal: J Minim Invasive Gynecol. 2017 Sep-Oct;24(6):940-945. doi: 10.1016/j.jmig.2017.04.027. Epub 2017 May 24. PMID: 28552655