Hysteroscopy and adenomyosis

Adenomyosis, a disease of the myometrium, can be diagnosed by hysteroscopy. Histologic specimens removed by transcervical punch biopsies or loop resection give more information on the depth of the adenomyosis. Symptomatic superficial adenomyosis can be treated sufficiently by transcervical endometrial coagulation or resection but can lead to iatrogenic adenomyosis, which can be treated by second-look hysteroscopy. Adenomyosis may also be caused by incomplete transcervical endometrial ablation or resection. In selected cases, hysteroscopic treatment of symptomatic focal adenomyosis becomes possible.