Question
The surgery of choice for diffuse endometriosis interna is :
| A. |
Total hysterectomy |
| B. |
Localised excision of the affected area |
| C. |
Hysterectomy + Oophorectomy |
| D. |
Oophorectomy |
Show Answer
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Correct Answer » A Explanation |
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Endometriosis interna is another term for adenomyosis, in which endometrial glands and stroma are present within the myometrium.
In diffuse adenomyosis, the disease involves the uterus diffusely, making localized excision impractical. Therefore, the definitive treatment for women with severe symptoms who have completed childbearing is total hysterectomy.
Routine removal of the ovaries is not necessary unless there is coexisting ovarian pathology, severe pelvic endometriosis, or other indications.
Explanation of Each Option
A. Total hysterectomy
Correct.
- Definitive treatment for diffuse adenomyosis.
- Removes the diseased uterus and provides the highest chance of symptom relief.
- Preferred in women who have completed childbearing.
B. Localized excision of the affected area
Incorrect.
- Suitable only for focal adenomyosis (adenomyoma).
- Not effective for diffuse adenomyosis, where the entire myometrium is involved.
C. Hysterectomy with bilateral oophorectomy
Incorrect.
- Bilateral oophorectomy is not routinely indicated for adenomyosis.
- Reserved for women with coexisting ovarian endometriosis, significant pelvic endometriosis, or other ovarian pathology.
D. Oophorectomy
Incorrect.
- Removing the ovaries alone does not remove the diseased uterus.
- Symptoms may persist because adenomyosis is confined to the uterus.
