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
Chapter

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.

Keywords

Adenomyosis Cystic adenomyosis 3D Ultrasound Hysteroscopy Treatment 

References

  1. 1.
    Tamai K, et al. Spectrum of MR features in adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006;20(4):583–602.CrossRefPubMedGoogle Scholar
  2. 2.
    Takeuchi H, et al. Diagnosis, laparoscopic management, and histopathologic findings of juvenile cystic adenomyoma: a review of nine cases. Fertil Steril. 2010;94(3):862–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Kamio M, et al. Isolated adenomyotic cyst associated with severe dysmenorrhea. J Obstet Gynaecol Res. 2007;33(3):388–91.CrossRefPubMedGoogle Scholar
  4. 4.
    Nabeshima H, et al. Total laparoscopic surgery of cystic adenomyoma under hydroultrasonographic monitoring. J Am Assoc Gynecol Laparosc. 2003;10(2):195–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Takeda A, et al. Laparoscopic management of juvenile cystic adenomyoma of the uterus: report of two cases and review of the literature. J Minim Invasive Gynecol. 2007;14(3):370–4.CrossRefPubMedGoogle Scholar
  6. 6.
    Tamura M, et al. Juvenile adenomyotic cyst of the corpus uteri with dysmenorrhea. Tohoku J Exp Med. 1996;178(3):339–44.CrossRefPubMedGoogle Scholar
  7. 7.
    Buerger PT, Petzing HE. Congenital cysts of the corpus uteri. Am J Obstet Gynecol. 1954;67(1):143–51.CrossRefPubMedGoogle Scholar
  8. 8.
    Koga K, et al. Images in reproductive medicine. A case of giant cystic adenomyosis. Fertil Steril. 2006;85(3):748–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Brosens I, et al. Uterine cystic adenomyosis: a disease of younger women. J Pediatr Adolesc Gynecol. 2015;28(6):420–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Koukoura O, et al. Laparoscopic treatment of a large uterine cystic adenomyosis in a young patient. BMJ Case Rep. 2015;2015:pii:bcr2015210358.CrossRefGoogle Scholar
  11. 11.
    Ryo E, et al. Radiofrequency ablation for cystic adenomyosis: a case report. J Reprod Med. 2006;51(5):427–30.PubMedGoogle Scholar
  12. 12.
    Giana M, et al. Large intramyometrial cystic adenomyosis: a hysteroscopic approach with bipolar resectoscope: case report. Eur J Gynaecol Oncol. 2005;26(4):462–3.PubMedGoogle Scholar
  13. 13.
    Gordts S, Campo R, Brosens I. Hysteroscopic diagnosis and excision of myometrial cystic adenomyosis. Gynecol Surg. 2014;11(4):273–8.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Kissler S, et al. Duration of dysmenorrhoea and extent of adenomyosis visualised by magnetic resonance imaging. Eur J Obstet Gynecol Reprod Biol. 2008;137(2):204–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Leyendecker G, Wildt L, Mall G. The pathophysiology of endometriosis and adenomyosis: tissue injury and repair. Arch Gynecol Obstet. 2009;280(4):529–38.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Bazot M, et al. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Hum Reprod. 2001;16(11):2427–33.CrossRefPubMedGoogle Scholar
  17. 17.
    Dueholm M, Lundorf E. Transvaginal ultrasound or MRI for diagnosis of adenomyosis. Curr Opin Obstet Gynecol. 2007;19(6):505–12.CrossRefPubMedGoogle Scholar
  18. 18.
    Reinhold C, Tafazoli F, Wang L. Imaging features of adenomyosis. Hum Reprod Update. 1998;4(4):337–49.CrossRefPubMedGoogle Scholar
  19. 19.
    Dueholm M, et al. Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis. Fertil Steril. 2001;76(3):588–94.CrossRefPubMedGoogle Scholar
  20. 20.
    Kepkep K, et al. Transvaginal sonography in the diagnosis of adenomyosis: which findings are most accurate? Ultrasound Obstet Gynecol. 2007;30(3):341–5.CrossRefPubMedGoogle Scholar
  21. 21.
    Naftalin J, Jurkovic D. The endometrial-myometrial junction: a fresh look at a busy crossing. Ultrasound Obstet Gynecol. 2009;34(1):1–11.CrossRefPubMedGoogle Scholar
  22. 22.
    Exacoustos C, et al. Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology. Ultrasound Obstet Gynecol. 2011;37(4):471–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Acien P. Incidence of Mullerian defects in fertile and infertile women. Hum Reprod. 1997;12(7):1372–6.CrossRefPubMedGoogle Scholar

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

Personalised recommendations