Surgical management of adenomyoma with hysteroscopy and laparotomy

A nulliparous woman presented with menorrhagia, anemia, and an enlarged uterus. A diagnosis of leiomyoma was made. At surgery, hysteroscopic resection was not possible because of the size of the mass. Laparotomy was performed and the uterus was opened through a “classical incision”. Hemostasis was secured with an intrauterine balloon. Histology revealed the mass to be an adenomyoma. Resecting an adenomyoma from the uterus can be complicated. Techniques, such as hysteroscopic examination before laparotomy, using a classical uterine scar, intrauterine balloon, and preoperative gonadotropin-releasing hormone analog may help to minimize the risks.