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The uterus is divided into three layers from the inside out: the endometrium, the myometrium, and the serosa. Adenomyosis is when the endometrium (including glands and stroma) invades the myometrium and grows, causing the uterus to enlarge, dysmenorrhea, increased menstrual flow, and decreased fertility. This condition seriously affects women's physical and mental health.
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The goal of treating adenomyosis is to relieve pain, reduce bleeding, and promote fertility. The treatment approach depends on factors such as age, severity of symptoms, and fertility requirements. Individualized, standardized treatment and long-term management are necessary.
Traditionally, adenomyosis is classified into two types: diffuse and localized lesions. However, this classification offers limited assistance in developing clinical treatment plans. Recently, a new classification based on MRI imaging has been proposed, dividing adenomyosis into the following four types:
Type I (Intrinsic): Adenomyosis lesions infiltrate the inner layer of the uterus without affecting the outer structure.
Type II (Extrinsic): Adenomyosis lesions infiltrate the outer layer of the uterus without affecting the internal structure.
Type III (Intramural): Lesions are confined to the myometrium and unrelated to the junctional zone or the serosa.
Type IV (Indeterminate): Lesions that do not fit into the above three categories are classified as Type IV.
Currently, the main treatment options for adenomyosis include medication (such as hormonal therapy and nonsteroidal anti-inflammatory drugs), focused ultrasound ablation, hysterectomy, and traditional Chinese medicine. The choice of treatment should be tailored to the type of lesion, patient's medical history, symptom characteristics, fertility needs, and economic situation to determine the most suitable single or combined treatment approach.
#Uterine #Adenomyosis #Gyn #Women #Fertility
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