الفهرس | Only 14 pages are availabe for public view |
Abstract The aim of this Study was to assess the effectiveness of Laparoscopic unipolar electro coagulation in the treatment of diffuse adenomyosis. 30 women, each of them had chronic pelvic pain and or menorrhagia, diagnosed by transvaginal ultrasound and or magnetic resonance imaging were subjected to CLEA . intra operative vasoconstrior agents as adrenaline and vasopressin were NOT used, instead of we use PGE1 analogue preoperatively, GnRH agonist was NOT used after myolysis . There were a significant improvement in every scale of the SF-36 (p < 0.0001), a significant reduction in the mean volume of the uterus after 12 months of the procedure (435.3- 247.5 cm3) initially and after 12 months, respectively, p <0, 0001). There was significant reduction in the mean scoring system of pain (VAS) (5.9-4.1) initially and after 12 months, respectively (p <0, 0001). Seventeen cases (56%) expressed their moderately satisfied with the procedure, eight cases (27%) were highly satisfied while five cases (17%) were not satisfied with the procedure. Two patients got pregnant after the procedure. One of them had first trimester miscarriage. The other one was had a full term pregnancy and was delivered by cesarean section. Laparoscopic Electro coagulation Adenomyolysis (CLEA) may be an effective and safer minimal invasive procedure for management of symptomatic adenomyosis. An optimal method for CLEA is not yet defined; however, the result of CLEA may be related to the level of experience of the physician performing the procedure. It is ad¬visable not to perform adenomyolysis in women who still want pregnancy More studies are needed to assess the safety, the effectiveness and side effects of CLEA in management of adenomyosis. |