Case Studies and Results :
Case 1. This 43-years old nullipara had a thirteen-year history of severe dysmenorrhea, lumbago and abdominal pain. Six years previously, she had undergone a laparotomy at another hospital which was concluded with observation only. After being advised to undergo an STH, she visited our clinic.
Pre- and post-operative MRIs for the patient are shown in Figure 2. The removed tissue weighed 215g, with a histopathology confirming adenomyosis and a left chocolait cyst. As a results of the operation, her serum CA-125 decreased from 257.5 U/ml to 48.0 U/ml. Menstruation returned to normal without the previous symptoms.
Case 2.This 46-years old 2 parous woman had an eight-year history of hypermenorrhea and severe anemia. She had undergone vigorous treatment at another university with Danazol at 400mg/day for five different 3-month periods, followed by Buserelin for 3-months.
The patient's pre- and post-operative MRIs are shown in Figure 3. The removed tissue weighed 175g, with histological diagnosis confirming adenomypsis. Following the opration, her symptoms disappeared and menstruation became normal. In addition, her pre-operative CA-125 value of 70.7 U/ml dropped to 6.6 U/ml.
| Figure 3 | ||
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| Preoperative MRI of adenomyosis uteri | Postoperative MRI of adenomyosis uteri | |
Case 3.This 49-years old nullipara had a 3-year history of severe dysmenorrhea, hypermenorrhea and anemia (Hb=7.3 g/dl). Because her symptoms were refractory to hormonotherapy as well as herb therapy, STH had been recommended to cure her severe anemia.
Pre-operative and post-oprative MRIs for the patient are shown in Figure 4. The removed tissue weighed 575g and was diagnosed histologically as diffuse adenomyosis with small myoma knots. Her serum CA-125 decreased from a pre-operative value of 140.1 U/ml to 41.8 U/ml, while her Hb improved to 11.4 g/dl.
| Figure 4 | ||
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| Preoperative MRI of adenomyosis uteri | Postoperative MRI of adenomyosis uteri | |
Summary of results.Table I gives a statistical summary of the pre- and post-oprative test results for the CA-125, RBC, Ht, and Hb examinations. As is evident from the table, the two-tailed sign test indicatied highly significant improvements for each of the measures.
