LAPAROSCOPIC BIPOLAR COAGULATION FOR THE CONSERVATIVE TREATMENT OF ADENOMYOMATA

Study Objective. To assess the effectiveness oi treating adenomyomata with laparoscopic bipolar coagulation. Design. Prospective, observatio nal study. Setting. The gynecology department oi a community hospital. Patients. Ten women, each with severe dysmenorrhea, chronic menorrhag ia, and adenomyomata diagnosed by magnetic resonance imaging. interven tions. Laparoscopic bipolar coagulation oi adenomyomata. Measurements and Main Results. The mean (+/- SEM) total adenomyoma volume before le uprolide acetate administration was 119 +/- 16 cm(3) (range 6-190 cm(3 )); alter 3 months of therapy this was reduced to 86 +/- 8 cm(3) (rang e 6-162 cm(3), p<0.0001) a 27.7% reduction. Further reduction occurred ? to 12 months postoperatively to 31 +/- 3.4 cm(3) (range 3-155 cm(3) , p<0.0001), a 73.9% reduction from baseline. Twelve months postoperat ively: seven (70.0%, p<0.05) women had continued resolution or signifi cant reduction of dysmenorrhea and resolution of menorrhagia. One woma n (10.0%) with unresolved dysmenorrhea and menorrhagia required hyster ectomy, and two (20.0%) with recurrent menorrhagia required resection of the endomyometrium; one continued to have menorrhagia but refused f urther surgical or medical treatment Conclusions. Conservative treatme nt obviated the need for major surgery in 90% of women with adenomyoma ta, but further evaluation of this technique is necessary to determine its definitive role.