Generally speaking, adenomyosis is not suitable for surgical removal. Adenomyosis is often a diffuse infiltrative process.

Can you remove adenomyosis with surgery?

Unlike fibroids, which can be easily separated from the normal uterine wall, adenomyotic tissue does not have a clear boundary with the normal myometrium.

Surgeons often find it difficult to determine where adenomyosis stop and where normal myometrium starts. The removal is either incomplete, leaving behind adenomyotic tissue which can continue to grow and cause problems, or a larger than necessary amount of normal myometrium around the adenomyosis might have to be removed.

Surgeons might have been misled by incorrect ultrasound diagnosis and inadvertently went ahead with surgery, with the intention to remove a “fibroid”. Half way through the surgery, it is then realized that the “fibroid” cannot be separated out from uterus and in fact it was adenomyosis that they are dealing with, and that surgery might need to be abandoned.

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