Hysteroscopy pp 471-478 | Cite as

Adenomyosis and Hysteroscopy: An Up-to-Date Review

Chapter

Abstract

Adenomyosis is a heterogeneous and benign gynecological condition that has an important impact on women in reproductive age. Adenomyosis often remains undiagnosed before a hysterectomy. An earlier diagnosis of adenomyosis requires a comprehensive medical history and a correlation of clinical examination and imaging findings, either ultrasound or MRI. Hysteroscopy can have both diagnostic and therapeutic uses regarding adenomyosis. With the improvement of the quality of mini-hysteroscopy, the hysteroscopy can be integrated as a first-line tool for diagnosis in context of abnormal uterine bleeding, infertility, or dysmenorrhea. Also, the hysteroscopy offers the possibility to perform biopsy of endomyometrial tissue under direct vision. Conservative treatment has been introduced since imaging technology and hysteroscopy have enabled the presumptive diagnosis of uterine adenomyosis in symptomatic women who want to preserve their uterus. The treatment options are depending on the age of the patients, the willingness to conceive, the type, size, and location of the lesion involve. Hysteroscopy is less invasive than laparoscopy and laparotomy for treating adenomyotic cysts. The impact of adenomyosis on fertility and failure of implantation is still debated, and treatment of adenomyosis is still lacking in the context of infertility. The aim of this chapter is to describe the importance of the diagnosis of adenomyosis by hysteroscopy and to analyze new therapeutic strategies.

Keywords

Adenomyosis Office hysteroscopy Biopsy Spirotome Adenomyotic cyst Adenomyoma 

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyChaim Sheba Medical CenterTel-HashomerIsrael
  2. 2.Sackler Faculty of MedicineTel-Aviv UniversityTel-HashomerIsrael

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