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Wang Xiu-Jun
NEW DEVELOPMENTS
ON
THE
MANAGEMENT
OF
''ADENOMYOSIS'
OF
THE
WOMB
"Adenomyosis"
is a
common dis-
ease due to
a
"growing
in"
of the cavity
lining of the womb into
the
underneath
muscle
layers.
20-50% also harbor fi-
broids (benign tumors
of
the
womb
muscle), some others have an infection
occurring
inside
the
pelvic cavity. Most
patients present as painful periods or
profuse
menses.
The womb
is
enlarged
significantly but evenly (unless compli-
cated
by
fibroids).
For cases not de-
tected
by
simpler radiological
means
involving ultrasound, magnetic reso-
nance imaging (MRl),
though
expensive, may be required for a
de-
finitive diagnosis. Other patients
may
have
their
diagnosis
confirmed
by
a
special internal "scope"
that
is
inserted
into
the womb cavity
for a
direct vision
-
the "hysteroscope" with which tissues
may
also
be
taken
out for examination
under
the
microscope.
More severe
cases aged
over
40 would usually have
the entire womb removed
surgically.
For
younger
patients
with
milder diseases,
especially those wishing to conceive,
a
conservative operation
involves only
the
lining of
the
womb cavity so as
to
pre-
serve the
organ.
Gonadotrophin-releas-
ing hormone agonists (GnRHa)
have
also
been advocated
to
render
more
severe cases suitable for the conser-
vative
operation
but
side
effects of the
hormone must also be noted.
Recently,
medical treatment
in the
form
o1
a LNG-
IUS (levo-nor-gestrel
intra-uterine
system)
has also been investigated as
an alternative. Consult your doctor!
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