Long-term efficacy and quality of life associated with laparoscopic bilateral uterine artery occlusion plus partial resection of symptomatic adenomyosis

摘要

Objective: To assess the long-term efficacy and quality of life associated with laparoscopic bilateral uterine artery occlusion plus partial resection of symptomatic adenomyosis. Study design: A total of 182 eligible patients with symptomatic adenomyosis were treated by laparoscopic bilateral uterine artery occlusion plus partial resection of adenomyosis from July 2003 to July 2009. Menstrual blood loss was measured using a pictorial blood loss assessment chart. Pain intensity during menstruation was evaluated on a 10-point visual analog scale (VAS). Health-related quality of life was measured using the WHOQOL-BREF. Results: A total of 179 patients with 3 years follow-up were enrolled in this retrospective study. No severe complications were noted during the surgical procedure or follow-up period. The mean postoperative dysmenorrhea and menorrhagia scores were significantly improved (all p < 0.01) at 3,12 and 36 months postoperatively, compared with preoperative scores. The volume of the uterus was continuously reduced at 3, 6,12 and 36 months postoperatively, and had shrunk by 58.3% at 36 months after surgery, compared with the preoperative volume. Notably, only 1.7% (3/179) of patients had received a hysterectomy at 36 months follow-up. In addition, patient's health-related quality of life scores were significantly increased (p < 0.01) compared with preoperative scores. Conclusion: Laparoscopic bilateral uterine artery occlusion plus partial resection of symptomatic adenomyosis is effective. There was a very low recurrence rate detected by ultrasound at 36 months.