The treatment for symptomatic adenomyosis has been hysterectomy. The reported mortality and morbidity rates for this procedure are 1-2 deaths per 1000 cases and 25-50%, respectively.
More conservative treatments are increasingly being used to treat adenomyosis. Gonadotropin-releasing hormone (GnRH) agonists have been used to treat the infertility that can result from adenomyosis. Adenomyosis has also responded to estrogen.
Embolization with polyvinyl particles through the uterine arteries may decrease the size of leiomyomas, which are seen as vascular masses, and it may also relieve the signs or symptoms of adenomyosis. For example, uterine-artery embolization may relieve the heavy vaginal bleeding that patients with adenomyosis often experience. Kim and colleagues were able to relieve the symptoms in 3 patients with MRI and/or ultrasonographic findings of adenomyosis. Long-term follow-up analysis of these patients, including their fertility subsequent to the procedure, is being conducted.
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А что касается остеопороза, то, как общеизвестно, во всем мире совместно с агонистами при доброкачественных поражениях применяется add-back терапия.
Вполне согласен с Вами о длительности лечения. Однако, не стоит забывать о задачах, которые преследуются при терапии эндометриоза (аденомиоза, в частности). При купировании тазовых болей - одно, при бесплодии, обусловленном эндометриозом - другое.
С уважением, Роман Аскеров
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