{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:35:36Z","timestamp":1789421736942,"version":"build-2803163510"},"reference-count":89,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Adenomyosis is an intricate pathological condition that negatively impacts the uterus. It is closely related to the more well\u2010known endometriosis, with which it shares parallels in terms of diagnosis, therapy, and both microscopic and macroscopic features. The purpose of this narrative review is to give a clear univocal definition and outlook on the different, patient\u2010adapted, surgical treatments. MEDLINE and PubMed searches on these topics were conducted from 1990 to 2022 using a mix of selected keywords. Papers and articles were identified and included in this narrative review after authors' revision and evaluation. From the literature analysis, authors reported the following surgical techniques: laparoscopic double\/triple\u2010flap method, laparotomic wedge resection of the uterine wall, laparotomic transverse H\u2010incision of the uterine wall, laparotomic wedge\u2010shaped excision, and laparotomic complete debulking excision by asymmetric dissection technique. Each of these techniques has strengths and weaknesses, but the literature data on the pregnancy rate are somewhat limited. The only certain information is the risk of uterine rupture up to 6.0% after surgical treatment for uterine adenomyosis. Over the years, the surgical approach continued to reach a positive result by minimally invasive treatment, with less hospitalization, less postoperative pain, and less blood loss. Over the years, the gynecological surgeon has gained the skills, training and increasingly sophisticated surgical techniques to target effective therapy. That's why a hysterectomy is no longer the only surgical resource to treat adenomyosis, but in patients who wish to preserve the fertility, there is a wide variety of surgical alternatives.<\/jats:p>","DOI":"10.1002\/ijgo.15389","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T01:35:01Z","timestamp":1706578501000},"page":"512-526","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Adenomyosis and fertility\u2010sparing surgery: A literature appraisal"],"prefix":"10.1002","volume":"166","author":[{"given":"Giovanni","family":"Pecorella","sequence":"first","affiliation":[{"name":"Department of Gynecology, Obstetrics and Reproduction Medicine Saarland University  Homburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meletios P.","family":"Nigdelis","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Obstetrics and Reproduction Medicine Saarland University  Homburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radmila","family":"Sparic","sequence":"additional","affiliation":[{"name":"Clinic for Gynecology and Obstetrics University Clinical Centre of Serbia  Belgrade Serbia"},{"name":"Faculty of Medicine University of Belgrade  Belgrade Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Morciano","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Pia Fondazione \u201cCard. G. Panico\u201d  Lecce Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8426-8490","authenticated-orcid":false,"given":"Andrea","family":"Tinelli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, and CERICSAL (CEntro di RIcerca Clinico SALentino) \u201cVeris delli Ponti Hospital\u201d  Lecce Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmz049"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2006.01.007"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/det451"},{"issue":"1","key":"e_1_2_16_5_1","first-page":"10","article-title":"How old is endometriosis? Late 17th\u2010 and 18th\u2010century European descriptions of the disease","volume":"72","author":"Knapp VJ","year":"1999","journal-title":"Fertil Steril"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-014-3437-8"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14834"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.00970.x"},{"issue":"5","key":"e_1_2_16_9_1","first-page":"688","article-title":"Adenomyosis: symptoms, histology, and pregnancy terminations","volume":"95","author":"Levgur M","year":"2000","journal-title":"Obstet Gynecol"},{"key":"e_1_2_16_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1350840"},{"key":"e_1_2_16_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2016.1197200"},{"issue":"2","key":"e_1_2_16_12_1","first-page":"89","article-title":"Epidemiology of adenomyosis","volume":"38","author":"Upson K","year":"2020","journal-title":"Semin Reprod Med"},{"key":"e_1_2_16_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0189522"},{"key":"e_1_2_16_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-016-0185-6"},{"key":"e_1_2_16_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000505690"},{"key":"e_1_2_16_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14806"},{"key":"e_1_2_16_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13798"},{"key":"e_1_2_16_18_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2014.57.2.128"},{"key":"e_1_2_16_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.07.916"},{"key":"e_1_2_16_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2017.07.014"},{"key":"e_1_2_16_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dei021"},{"issue":"3","key":"e_1_2_16_22_1","first-page":"295","article-title":"Adenomyosis: fertility and obstetric outcome","volume":"70","author":"Buggio L","year":"2018","journal-title":"A Comprehensive Literature Review Minerva Ginecol"},{"key":"e_1_2_16_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0000000000000346"},{"issue":"12","key":"e_1_2_16_24_1","first-page":"3245","article-title":"Impact of adenomyosis on infertile patients\u2010therapy options and reproductive outcomes","volume":"10","author":"G\u00fcnther V","year":"2022","journal-title":"Biomedicine"},{"key":"e_1_2_16_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2010.01189.x"},{"key":"e_1_2_16_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-011-9640-7"},{"key":"e_1_2_16_27_1","doi-asserted-by":"publisher","DOI":"10.2217\/whe.15.60"},{"key":"e_1_2_16_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des012"},{"key":"e_1_2_16_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-022-02476-2"},{"key":"e_1_2_16_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2013.255"},{"key":"e_1_2_16_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/1933719116657192"},{"key":"e_1_2_16_32_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/786132"},{"key":"e_1_2_16_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/gaw042"},{"key":"e_1_2_16_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deu041"},{"key":"e_1_2_16_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.06.025"},{"key":"e_1_2_16_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-023-05895-w"},{"key":"e_1_2_16_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.01.032"},{"issue":"22","key":"e_1_2_16_38_1","first-page":"1174","article-title":"Conservative surgical treatment for adenomyosis uteri in young women: local excision and metroplasty","volume":"93","author":"Van Praagh I","year":"1965","journal-title":"Can Med Assoc J"},{"key":"e_1_2_16_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2010.09.014"},{"key":"e_1_2_16_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2010.04.015"},{"issue":"3","key":"e_1_2_16_41_1","first-page":"161","article-title":"Intrauterine synechiae after myomectomy; laparotomy versus laparoscopy: non\u2010randomized interventional trial","volume":"13","author":"Asgari Z","year":"2015","journal-title":"Iran J Reprod Med"},{"key":"e_1_2_16_42_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S205561"},{"key":"e_1_2_16_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2009.03.046"},{"key":"e_1_2_16_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003805"},{"key":"e_1_2_16_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2014.02.008"},{"key":"e_1_2_16_46_1","doi-asserted-by":"publisher","DOI":"10.1159\/000075830"},{"key":"e_1_2_16_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000014579"},{"key":"e_1_2_16_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000033266"},{"key":"e_1_2_16_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-015-0182-5"},{"key":"e_1_2_16_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2022.08.010"},{"key":"e_1_2_16_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2021.11.014"},{"key":"e_1_2_16_52_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.21025"},{"key":"e_1_2_16_53_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11123489"},{"key":"e_1_2_16_54_1","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2017.00014"},{"key":"e_1_2_16_55_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a137919"},{"key":"e_1_2_16_56_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoab030"},{"key":"e_1_2_16_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2013.10.025"},{"key":"e_1_2_16_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2013.01.007"},{"key":"e_1_2_16_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2008.00951.x"},{"key":"e_1_2_16_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2012.04.008"},{"key":"e_1_2_16_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2014.04.024"},{"key":"e_1_2_16_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2019.08.004"},{"key":"e_1_2_16_63_1","doi-asserted-by":"publisher","DOI":"10.1177\/1933719118756754"},{"key":"e_1_2_16_64_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dms006"},{"key":"e_1_2_16_65_1","doi-asserted-by":"publisher","DOI":"10.1067\/S0002-9378(03)01052-4"},{"key":"e_1_2_16_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0578.2007.00182.x"},{"key":"e_1_2_16_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2017.12.020"},{"key":"e_1_2_16_68_1","doi-asserted-by":"publisher","DOI":"10.1177\/1933719117750752"},{"key":"e_1_2_16_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2005.12.002"},{"issue":"5","key":"e_1_2_16_70_1","first-page":"555","article-title":"An experimental study of gastric healing following scalpel and diathermy incisions","volume":"79","author":"Rosin RD","year":"1976","journal-title":"Surgery"},{"issue":"1","key":"e_1_2_16_71_1","first-page":"39","article-title":"Laparoscopically assisted myomectomy: a report of a new technique in 57 cases","volume":"39","author":"Nezhat C","year":"1994","journal-title":"Int J Fertil Menopausal Stud"},{"key":"e_1_2_16_72_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016349009021046"},{"key":"e_1_2_16_73_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200407000-00060"},{"key":"e_1_2_16_74_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12799"},{"key":"e_1_2_16_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2020.09.023"},{"key":"e_1_2_16_76_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2017.1285895"},{"key":"e_1_2_16_77_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12604"},{"key":"e_1_2_16_78_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2011.05.008"},{"key":"e_1_2_16_79_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-10-100"},{"key":"e_1_2_16_80_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13159"},{"key":"e_1_2_16_81_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12093069"},{"key":"e_1_2_16_82_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep10034"},{"key":"e_1_2_16_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2013.08.022"},{"issue":"1","key":"e_1_2_16_84_1","first-page":"948","article-title":"Image\u2010guided thermal ablation in the management of symptomatic adenomyosis: a systematic review and meta\u2010analysis","volume":"38","author":"Liu L","year":"2021","journal-title":"Int J Hearth"},{"issue":"1","key":"e_1_2_16_85_1","article-title":"Pregnancy outcomes of adenomyotic patients with primary infertility after high\u2010intensity focused ultrasound treatment","volume":"40","author":"Xiong L","year":"2023","journal-title":"Int J Hearth"},{"key":"e_1_2_16_86_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2023.102433"},{"key":"e_1_2_16_87_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2019.07.029"},{"issue":"1","key":"e_1_2_16_88_1","article-title":"Magnetic resonance guided high intensity focused ultrasound for uterine fibroids and adenomyosis has no effect on ovarian reserve","volume":"40","author":"Otonkoski S","year":"2023","journal-title":"Int J Hearth"},{"key":"e_1_2_16_89_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000371"},{"key":"e_1_2_16_90_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13158"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.15389","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.15389","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.15389","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:58:15Z","timestamp":1772971095000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.15389"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,29]]},"references-count":89,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1002\/ijgo.15389"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.15389","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,29]]},"assertion":[{"value":"2023-08-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}