Surgical Options

Surgical care for adenomyosis is tailored to symptoms, reproductive goals, and how widely the uterine muscle is involved. Imaging—especially MRI and high‑quality ultrasound—helps distinguish focal adenomyomas from diffuse disease and guides the choice between uterus‑sparing procedures and definitive hysterectomy. When adenomyosis coexists with endometriosis, the plan may be adjusted to address both conditions comprehensively; see Imaging & Diagnosis (MRI, Ultrasound) and Endometriosis for context.

Uterus‑sparing options include laparoscopic adenomyomectomy (adenomyoma enucleation) for localized disease, using layered reconstruction to preserve strength for future pregnancy. For diffuse involvement, symptom‑focused options such as debulking, high‑intensity focused ultrasound (HIFU/MRgFUS), or uterine artery embolization (UAE) may help pain and bleeding but have uncertain fertility outcomes. Hysterectomy remains the most reliable solution for those finished with childbearing, with minimally invasive approaches generally enabling quicker recovery and ovarian preservation when appropriate. Learn how candidacy, risks, recovery, and future pregnancy planning intersect across choices; see Focal Adenomyosis, Diffuse Adenomyosis, and Fertility Considerations.