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Related Experiment Video

Updated: Jun 4, 2026

Introduction of Intracapsular Rotary-cut Procedures (IRCP): A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation
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Introduction of Intracapsular Rotary-cut Procedures (IRCP): A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation

Published on: January 17, 2019

Focal and Diffuse Adenomyomectomy: A Systematic Review of Comparative Outcomes From Published Studies Including 3397

Ahmet Kale1, Ebru Kale2, Sevil Çankaya1

  • 1Department of Obstetrics and Gynecology, Sancaktepe Prof. Dr. Ilhan Varank Training and Research Hospital, University of Health Sciences (Drs. A. Kale, Çankaya), Istanbul, Türkiye.

Journal of Minimally Invasive Gynecology
|June 2, 2026
PubMed
Summary

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Focal adenomyomectomy uses minimally invasive techniques for localized disease, while diffuse adenomyomectomy involves more complex surgery. Diffuse adenomyomectomy may offer better symptom relief and reproductive outcomes, with comparable obstetric safety.

Area of Science:

  • Gynecologic Surgery
  • Reproductive Medicine
  • Medical Research

Background:

  • Adenomyosis presents as either focal or diffuse lesions.
  • Surgical management via adenomyomectomy aims to alleviate symptoms and improve fertility.
  • Understanding the distinct characteristics of focal versus diffuse adenomyosis is crucial for surgical planning and patient counseling.

Purpose of the Study:

  • To compare focal and diffuse adenomyomectomy.
  • Evaluate differences in clinical presentation, surgical complexity, and outcomes.
  • Assess postoperative symptom relief and reproductive success.

Main Methods:

  • Systematic review and meta-analysis of PubMed/MEDLINE, Web of Science, and Embase databases.
  • Inclusion of 43 studies analyzing 3397 patients (1460 focal, 1937 diffuse).
Keywords:
AdenomyomectomyAdenomyosisDiffuse adenomyosisFocal adenomyosisLaparoscopyLaparotomy

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  • Independent data extraction by two investigators.

    • Main Results:

    • Diffuse adenomyosis more frequently associated with dysmenorrhea and infertility; focal with dyspareunia, chronic pelvic pain, and dyschezia.
    • Laparoscopy favored for focal, laparotomy for diffuse adenomyomectomy.
    • Diffuse adenomyomectomy showed higher rates of symptom relief (dysmenorrhea, menorrhagia) and improved pregnancy and live birth rates.
    • Obstetric complication rates were similar between groups.

    Conclusions:

    • Focal and diffuse adenomyomectomy are distinct approaches reflecting disease patterns and surgical complexity.
    • Focal adenomyomectomy is often amenable to minimally invasive surgery.
    • Diffuse adenomyomectomy may lead to greater symptom improvement and better reproductive outcomes.
    • Obstetric outcomes are comparable despite surgical differences.