Background: Previous studies had shown that major uterine wall
resection and reconstruction of the uterus (MURU) was safe and effective in the
treatment of adenomyosis. However, MURU results in loss of a significant amount
of myometrial and some endometrial tissues, which may have an impact on uterine
hemodynamics and ovarian function. Therefore, it is necessary to study the
changes of uterine hemodynamics and ovarian function in patients after MURU, in
order to provide an evidence-base for its clinical application.
Objective: To explore the effects of major uterine wall resection and
reconstruction of the uterus (MURU) on uterine hemodynamics and ovarian function
in patients with adenomyosis. Study design: The maximum
thickness of unilateral uterine muscle wall or the maximum diameters of
adenomyosis focus were measured by ultrasonography. Patients with adenomyosis
were divided into three groups: mild, moderate or severe. Fifty cases of
adenomyosis without fertility requirement were treated with MURU (observation
group), and levonorgestrel-releasing system (LNG-IUS) was placed in uterine
cavity during the operation. Fifty patients with intramural myoma of the uterus
were selected for hysteromyomectomy (control group). The changes of arterial
pulsation index (PI) and resistance index (RI) of uterine artery, as well as
antral follicle count (AFC) and serum antimullerian hormone (AMH) were observed
before operation and 1 month, 3 months, 6 months, 12 months and 18 months
post-operation. Results: No complications were observed in both
groups, no significant difference in uterine hemodynamics and ovarian function
were found between the two groups (P
