A 40-year-old woman is diagnosed with adenomyosis on MRI (heterogeneous enlarged uterus, junction zone thickness 14 mm). She has completed her family and has refractory menorrhagia. Which is the definitive treatment?

• A Levonorgestrel intrauterine system (Mirena)
• B Endometrial ablation
• C GnRH agonist long-term therapy
• D Total hysterectomy ✓

Explanation

Total hysterectomy is the only definitive cure for adenomyosis as it removes the affected myometrium entirely. Levonorgestrel IUS and GnRH agonists provide symptomatic relief but recurrence occurs on cessation. Endometrial ablation is contraindicated in adenomyosis because the condition is myometrial; outcomes are poor with high failure rates due to deep disease.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.