Surgical techniques for excision of juvenile cystic adenomyoma

Brought to you by the Society of Gynecologic Surgeons. In this video, the authors review causes of pelvic pain among adolescents and discuss surgical techniques for resection of juvenile cystic adenomyoma (JCA). JCAs are defined as cystic lesions larger than 1 cm in women younger than age 30 with severe dysmenorrhea, distinct from the uterine cavity, and surrounded by hypertrophic myometrium. They review the following techniques: 1) maximize visualization with a uterine manipulator and temporary oophoropexy, 2) optimize hemostasis via temporary uterine artery ligation, 3) complete ureterolysis, 4) meticulous enucleation of adenomyoma, and 5) excision of co-existent endometriotic lesions.