Adenomyosis, a lesion resulting from the invasion of the endometrium (both glandular and mesenchymal) into the myometrium and its growth, is a difficult gynecological condition. The main clinical symptoms of adenomyosis include dysmenorrhea, heavy menstrual flow, anemia, painful involvement and infertility. It has a great impact on women. Even some of the patients who come to the hospital for adenomyosis treatment reflect that they have to go to the hospital for a few days every month, and the painful periods are really painful and unbearable. But even if the pain is unbearable, the majority of adenomyosis patients still choose, can take medicine not injections, can injections not surgery, can minimally invasive not open abdomen. So adenomyosis, must be treated surgically? Adenomyosis, which treatment is considered, depends on the situation. First, no painful menstruation, menstrual flow is also not large, the symptoms are not obvious Some adenomyosis patients, is a physical examination occasionally found to have adenomyosis, usually menstruation, there are no symptoms, no painful menstruation, nor anemia, there is no abnormalities, this situation of adenomyosis patients do not need surgery, to observe the main, regular review. If you have fertility requirements, actively prepare for pregnancy, and do not have too much psychological burden. Second, adenomyosis, with dysmenorrhea, but the pain can be tolerated, or painkillers can relieve, the uterus is not large For this type of adenomyosis patients, you can take some painkillers to relieve during menstruation, however, painkillers are also not recommended to eat much, because they can cause damage to the liver and kidneys. You can also consider getting a Manometra ring first. In some patients with adenomyosis, the symptoms of menstrual pain will be relieved and the volume of menstruation will be less after getting a Mannorrhea. Mannorrhea, mainly, provides temporary relief. However, the use of Manuelle has limitations and is not suitable for all patients. If the uterus is too large and the menstrual flow is too heavy, the ring will easily move down or fall off after Manuelle. Even patients with a small uterus may show a series of side effects after getting the ring, so it is necessary to try it to know whether it is suitable or not. If you can adapt to it, you can continue to wear it. If you can’t adapt to it, you should consider surgery. Third, severe menstrual pain, anemia, large uterus For adenomyosis patients with obvious symptoms, severe menstrual pain, severe anemia, too large uterus, these symptoms, as long as one of the symptoms, you should consider surgery. Surgery for adenomyosis, of course, is divided into radical surgery and conservative surgery. Radical surgery is the direct removal of the uterus to “put an end to it forever”. The direct removal of the uterus is unacceptable to many women. Other patients with adenomyosis, who have fertility requirements, are not willing to consider having their uterus removed directly. The only options left for conservative surgery are minimally invasive surgery (laparoscopic, hysteroscopic, interventional…) and adenomyosis conserving surgery. However, due to the limitations of minimally invasive, generally minimally invasive can only be operated by instruments, coupled with the diffuse nature of adenomyosis, so relying on minimally invasive can not solve all adenomyosis lesions, if you do not solve once, you have to consider the second surgery, so more traumatic. Minimally invasive surgery is generally not recommended for patients with adenomyosis. Younger patients with adenomyosis who have fertility needs and do not want to cut the uterus can consider adenomyosis conserving surgery, which only removes the lesions and preserves the uterus. After the surgery, the menstrual flow will be significantly reduced, the dysmenorrhea problem will be solved to a large extent, the anemia symptoms will slowly improve, the feeling of anal swelling will disappear, and normal work and life will be resumed. For adenomyosis patients with fertility requirements, I usually advise them to prepare for pregnancy as soon as possible to see if they can conceive, because adenomyosis is a progressive aggravation of the disease, the longer you delay, the symptoms become more and more obvious, the intrauterine environment becomes worse, so it is less easy to get pregnant. Therefore, those who have the need to have children should actively prepare for pregnancy first. If you have been unsuccessful in preparing for pregnancy, you can also come over for uterine preservation surgery first, and then evaluate and prepare for pregnancy 1-2 years later, depending on your condition.