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Cystic Adenomyosis: Place of Hysteroscopic Approach

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Hysteroscopy

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Abstract

Cystic adenomyosis is not very common. Primary complains are chronic pelvic pain, severe dysmenorrhea, and heavy menstrual bleeding when they are associated with superficial or diffuse adenomyosis. The introduction of 3D-TransVaginal UltraSound (3D-TVUS) with coronal view and/or Magnetic Resonance Imaging (MRI) increased the number of cases reported. Despite the severity of symptoms in symptomatic forms, it is unclear whether cystic adenomyosis impairs reproductive outcome. Therefore, for women wishing to become pregnant, evaluation of uterine cavity by hysteroscopy and exploration of the sub-endometrial zone by 3D-TVUS is becoming a gold standard.

In case of symptomatic cystic adenomyosis or asymptomatic cystic adenomyosis associated with infertility, surgery must be discussed either by hysteroscopy with dissection and ablation or vaporization of the cystic wall, or by laparoscopy in case of large cystic adenomyosis.

Further studies will be necessary to evaluate the impact of cystic adenomyosis removal on fertility outcomes.

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Authors and Affiliations

  1. Service Gynécologie Obstétrique, AP-HP, CHU Bicêtre, 78 rue du Général Leclerc, 94270, Le Kremlin Bicêtre, France

    Hervé Fernandez, Yaël Levy-Zauberman, Solène Vigoureux, Anne-Gaëlle Pourcelot, Jean-Marc Levaillant & Perrine Capmas

  2. Faculté de Médecine, Paris-Sud Saclay, 63 rue Gabriel Péri, 94270, Le Kremlin Bicêtre, France

    Hervé Fernandez & Solène Vigoureux

  3. CESP-INSERM U1018 “Reproduction et Développement de l’enfant”, 82 rue Gabriel Péri, 94270, Le Kremlin Bicêtre, France

    Hervé Fernandez & Perrine Capmas

Authors
  1. Hervé Fernandez
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  2. Yaël Levy-Zauberman
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  3. Solène Vigoureux
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  4. Anne-Gaëlle Pourcelot
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  5. Jean-Marc Levaillant
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  6. Perrine Capmas
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Corresponding author

Correspondence to Hervé Fernandez .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynaecology, Ospedale Vito Fazzi, Lecce, Italy

    Andrea Tinelli

  2. Hysteroscopy Unit, Gutenberg Institute, Malaga, Spain

    Luis Alonso Pacheco

  3. Hysteroscopy Unit, Hospital Del Mar, Barcelona, Spain

    Sergio Haimovich

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Fernandez, H., Levy-Zauberman, Y., Vigoureux, S., Pourcelot, AG., Levaillant, JM., Capmas, P. (2018). Cystic Adenomyosis: Place of Hysteroscopic Approach. In: Tinelli, A., Alonso Pacheco, L., Haimovich, S. (eds) Hysteroscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-57559-9_44

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  • DOI: https://doi.org/10.1007/978-3-319-57559-9_44

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-57558-2

  • Online ISBN: 978-3-319-57559-9

  • eBook Packages: MedicineMedicine (R0)

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