Hysteroscopy pp 493-499 | Cite as

Cystic Adenomyosis: Place of Hysteroscopic Approach

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


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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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Hervé Fernandez
    • 1
    • 2
    • 3
  • Yaël Levy-Zauberman
    • 1
  • Solène Vigoureux
    • 1
    • 2
  • Anne-Gaëlle Pourcelot
    • 1
  • Jean-Marc Levaillant
    • 1
  • Perrine Capmas
    • 1
    • 3
  1. 1.Service Gynécologie ObstétriqueAP-HP, CHU BicêtreLe Kremlin BicêtreFrance
  2. 2.Faculté de MédecineParis-Sud SaclayLe Kremlin BicêtreFrance
  3. 3.CESP-INSERM U1018 “Reproduction et Développement de l’enfant”Le Kremlin BicêtreFrance

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