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  • Title: Laparoscopic bipolar coagulation for the conservative treatment of adenomyomata.
    Author: Phillips DR, Nathanson HG, Milim SJ, Haselkorn JS.
    Journal: J Am Assoc Gynecol Laparosc; 1996 Nov; 4(1):19-24. PubMed ID: 9050706.
    Abstract:
    STUDY OBJECTIVE: To assess the effectiveness of treating adenomyomata with laparoscopic bipolar coagulation. DESIGN: Prospective, observational study. Setting. The gynecology department of a community hospital. PATIENTS: Ten women, each with severe dysmenorrhea, chronic menorrhagia, and adenomyomata diagnosed by magnetic resonance imaging. INTERVENTIONS: Laparoscopic bipolar coagulation of adenomyomata. MEASUREMENTS AND MAIN RESULTS: The mean (+/- SEM) total adenomyoma volume before leuprolide acetate administration was 119 +/- 16 cm3 (range 6-190 cm3); after 3 months of therapy this was reduced to 86 +/- 8 cm3 (range 6-162 cm3, p <0. 0001) a 27.7% reduction. Further reduction occurred 7 to 12 months postoperatively to 31 +/- 3.4 cm3 (range 3-155 cm3, p <0.0001), a 73.9% reduction from baseline. Twelve months postoperatively, seven (70.0%, p <0.05) women had continued resolution or significant reduction of dysmenorrhea and resolution of menorrhagia. One woman (10.0%) with unresolved dysmenorrhea and menorrhagia required hysterectomy, and two (20.0%) with recurrent menorrhagia required resection of the endomyometrium; one continued to have menorrhagia but refused further surgical or medical treatment. CONCLUSIONS: Conservative treatment obviated the need for major surgery in 90% of women with adenomyomata, but further evaluation of this technique is necessary to determine its definitive role.
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