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.
Adenomyosis Cystic adenomyosis 3D Ultrasound Hysteroscopy Treatment
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