Surgery is necessary when the adenomyosis is so large that dysmenorrhea cannot be relieved by medication, when the menstrual flow increases and causes anemia, or when the uterus is so large that it causes frequent urination and urinary retention and constipation. 1. Dysmenorrhea that cannot be relieved by medication: Adenomyosis is a condition in which the endometrium and glands are spread into the myometrium, and with the cyclic peeling of the endometrium, there is a progressive worsening of dysmenorrhea. Some dysmenorrhea can be treated with medications, such as ibuprofen, a nonsteroidal anti-inflammatory drug, etc. If the dysmenorrhea cannot be relieved by medications, the adenomyosis can be surgically removed. 2. Anemia caused by increased menstrual flow: adenomyosis due to increased endometrial area, menstrual flow will also increase, if the long-term excessive menstrual flow caused by severe iron-deficiency anemia, the need for surgical resection of the foci, women of childbearing age can be removed from the foci of the adenomyosis, menopausal women can be carried out whole uterus plus double adnexectomy. 3. The uterus is too large to cause frequent urination, urinary retention, constipation: when the adenomyosis is too large, it will compress the bladder in the front and the rectum in the back. When it presses on the bladder, it will cause frequent urination and even urinary retention, and when it presses on the rectum, it will cause constipation, which will also need to be treated with surgical removal. It is recommended that people with adenomyosis should follow up regularly and not undergo hysterectomy if there is no indication for surgery, and if surgery is necessary, they should consult a medical professional for treatment.