Adenomyosis is a benign disease of the uterus caused by ectopic endometrium to the myometrium, which is divided into diffuse and focal types, and the focal type is what used to be called adenomyoma. The focal type is what used to be called adenomyoma. The main causes are multiple miscarriages, childbirth, uterine trauma during cesarean section and chronic endometritis, which mostly occurs in young and middle-aged women during their reproductive years. Increasingly severe dysmenorrhea is its typical symptom, often accompanied by menstrual disorders, anemia, infertility, and painful intercourse. Adenomyosis is not a tumor, it has no envelope and is difficult to be removed completely by conventional surgery. Traditional treatment methods include: (1) medication: hormonal drugs are used to adjust the patient to the menopausal state, with heavy liver and kidney damage, heavy masculinization, poor efficacy and relapse after stopping medication. (2) Lesion debridement: the recurrence rate is extremely high, and recurrence occurs after 2-3 menstrual periods after surgery. (3) Hysterectomy: at the cost of organ removal, highly traumatic. The interventional treatment of adenomyosis is to cut a rice-sized hole at the root of one thigh, insert a special catheter into the blood supply artery of the adenomyosis lesion, and apply an embolic agent to block the blood supply to the lesion to “starve” the adenomyosis. The procedure takes less time and is usually completed in about one hour. Interventional treatment is done under intravenous analgesia, so the procedure is painless and the hospital stay is short. After more than 20 years of clinical observation, interventional treatment is already a mature technology. Within 1-3 months after treatment, patients’ dysmenorrhea basically or completely disappears and menstruation returns to normal, and within 3-5 months, the uterus shrinks and softens significantly, and fertility can be preserved. Interventional treatment of adenomyosis is effective, preserves organs and fertility, is minimally invasive, and does not enter the abdominal cavity, does not interfere with the intra-abdominal environment, does not have to worry about complications such as intestinal adhesions and intestinal obstruction, and is the best treatment option for adenomyosis to preserve the uterus. The interventional treatment of uterine fibroids With the development of modern society, the number of patients with uterine fibroids is increasing, and its incidence shows two major trends: first, the incidence is increasing, according to incomplete statistics, 1 out of 4-5 women over 30 years old have the disease, becoming a veritable first tumor in women; second, the age of onset is getting younger and younger, the youngest among the patients we treat is 21 years old. Therefore, the prevention and treatment of uterine fibroids must be taken seriously. The traditional treatment for uterine fibroids is surgical resection, with the three main procedures being total hysterectomy, hysterectomy and myomectomy, which can be done through three routes: transabdominal, transvaginal and transabdominal laparoscopic. In the first two cases, the fibroids are removed together with the normal uterus, while in the latter case, the uterus is cut open and the fibroids are excavated, either way at the cost of damaging the uterus or removing it. Minimally invasive interventional treatment of fibroids is a specific application of minimally invasive medicine in the field of obstetrics and gynecology, which perfectly embodies the concept of minimally invasive treatment and realizes the patient’s dream of treating fibroids without damaging the uterus, making the treatment of fibroids more humane. According to the principles of minimally invasive gynecological therapeutics, the principles of minimally invasive treatment should be followed when choosing the treatment method for uterine fibroids, namely: (1)
best clinical efficacy; (2) smallest surgical incision; (3) shortest treatment time; (4) minimal organ damage; (5) minimal postoperative reaction; (6) fastest recovery; and (7)
minimal psychological trauma. Specifically, if drug therapy is effective, surgery is not necessary; if interventional therapy is also effective, there is no need to resort to open surgery. At present, the treatment of uterine fibroids advocates humane treatment, which means that the best treatment method is chosen for the patient according to the condition, among which minimally invasive interventional treatment is one of the most humane methods, which is called uterine artery embolization. Unlike traditional surgical treatment, which treats the disease at the expense of normal organs, minimally invasive interventional techniques treat the disease without damaging or minimizing normal organs, in line with the current principles of minimally invasive gynecology. This technology has been applied in obstetrics and gynecology clinics for nearly 40 years and in the treatment of uterine fibroids for more than 10 years. At present, hundreds of thousands of patients with fibroids have benefited from it worldwide, and some patients with fertility requirements have fulfilled their dream of becoming mothers. The procedure involves cutting a small hole the size of a grain of rice at the root of the patient’s thigh, inserting a special catheter into the blood supply artery of the fibroid and then applying a biodegradable embolic agent to embolize the fibroid artery, causing the fibroid to necrosis due to ischemia and hypoxia, usually without damaging the normal uterus. After surgery, the necrotic fibroids are either discharged vaginally or absorbed by the body. Can fibroids recur after minimally invasive interventions? The fibroids appear necrotic after interventions, so there is no problem of recurrence of the original fibroids, which is supported by domestic and foreign cases and our data. Since the uterus is still normal, there is still a chance of myoma regrowth. According to statistics, the 5-year regrowth rate is about 3%, which is significantly lower than the recurrence rate after myoma removal (20% at 2 years and 50% at 5 years after surgery). Can I have children after minimally invasive intervention for fibroids? Fibroids themselves can lead to infertility, with an incidence of 25%-40%. With the disappearance of fibroids after interventional treatment, the factors that cause infertility due to fibroids disappear and the patient’s chances of conception increase. There have been reports of pregnancy and delivery of normal fetuses after interventional treatment in China and abroad, and we have also had cases of pregnancy after treatment.