Paper presentation on Comparison of Medical versus Surgical Management of Adenomyosis for gynec resident doctor
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Adenomyosis Medical vs Surgical Management
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What's Inside (14 Slides)
| Slide | Content |
|---|---|
| 1 | Title slide |
| 2 | Presentation outline |
| 3 | Definition, Epidemiology & Pathophysiology |
| 4 | Clinical Features & Diagnosis (MUSA criteria, MRI, histology) |
| 5 | Overview of all management strategies |
| 6 | Medical Management - 8 drug classes with mechanisms & evidence |
| 7 | Procedural/Minimally Invasive interventions (HIFU, UAE, RFA, PMWA, ablation) |
| 8 | Surgical management (adenomyomectomy techniques + hysterectomy) |
| 9 | Head-to-head comparison table across 12 parameters |
| 10 | Fertility considerations & recurrence rates |
| 11 | Current evidence 2021-2025 with 4 key studies cited |
| 12 | Clinical decision algorithm (step-by-step) |
| 13 | 9 Key takeaways |
| 14 | Full references |
Key Clinical Points Highlighted
- Dienogest vs LNG-IUS: Dienogest is superior for pain and uterine volume reduction; LNG-IUS is better for correcting anaemia (Akhigbe et al. 2024 meta-analysis, PMID 39032312)
- HIFU + GnRH-a combination outperforms either alone (Song & Wang 2025 NMA, PMID 39648811)
- Adenomyomectomy carries ~6% uterine rupture risk in subsequent pregnancy - much higher than myomectomy (0.26%)
- Total hysterectomy (not subtotal) is the definitive cure; cervical stump recurrence reported with subtotal
- No medical therapy is curative - all require long-term or maintenance strategies
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