Ms. Wu, a 45-year-old woman, has long suffered from adenomyosis. Over the past year, she has experienced extremely heavy menstrual bleeding—so severe that even nighttime maxi pads cannot contain it. Her hemoglobin levels have frequently dropped below 6.0 gm/dL (normal range for women: 12.0–16.0 gm/dL), less than half the healthy level. This severe anemia has necessitated multiple emergency blood transfusions, significantly affecting both her personal life and work.Complicating matters, Ms. Wu has a thrombotic condition that requires long-term anticoagulant therapy, making it difficult to manage her bleeding. Due to the risk of thrombosis, she is unable to use common hormonal medications. Her uterus, enlarged by adenomyosis, had grown to the size of a 20-week pregnancy (approximately 20–22 cm, compared to the normal size of about 7 cm). Faced with the triple challenges of “difficulty in surgical treatment due to uterine enlargement, high bleeding risk, and limited medical options,” Ms. Wu felt helpless.Adenomyosis is a common gynecological condition affecting approximately 20% to 35% of women. It is primarily caused by endometrial tissue invading the myometrium. Common symptoms include severe menstrual cramps, heavy bleeding, prolonged periods, and uterine enlargement. In severe cases, blood transfusions may be necessary to stabilize anemia.Dr. Chen Jialin of the Department of Obstetrics and Gynecology at Kuang Tien General Hospital notes that many patients delay seeking medical attention, mistakenly believing they are only experiencing menstrual cramps or anemia. Others confuse the uterine enlargement caused by adenomyosis with uterine fibroids, which are more common and often lead to misdiagnosis. The symptoms of adenomyosis typically worsen with age and require long-term, comprehensive treatment.Clinically, treatment options for adenomyosis fall into three main categories: medication (hormonal therapy or symptomatic relief), non-invasive or minimally invasive procedures (e.g., HIFU, microwave ablation), and surgery (e.g., traditional laparotomy or minimally invasive surgery). However, for Ms. Wu—who suffers from a thrombotic disorder, requires long-term anticoagulants, experiences heavy bleeding, and has a uterus enlarged beyond 20 cm—medication is not viable, and non-invasive treatments are insufficient. Traditional surgery also poses significant risks due to potential thrombotic complications from excessive bleeding and postoperative immobility. After thorough consultation, the medical team opted for a hysterectomy using the da Vinci minimally invasive procedure.Thanks to its combination of 3D high-definition vision and a flexible robotic arm, the da Vinci system enables precise identification and removal of lesions while minimizing damage to surrounding organs and blood vessels. Even with an enlarged uterus, tissue structures can be clearly visualized, greatly enhancing surgical safety. Compared to conventional surgeries, the da Vinci procedure offers smaller incisions, minimal bleeding, and a significantly faster recovery. Dr. Chen Jialin reports that most patients are discharged within 3 to 5 days and can resume daily activities in about two weeks. The risk of infection and complications is also relatively low. For high-risk patients like Ms. Wu, the minimally invasive nature of the da Vinci procedure is especially beneficial.Dr. Chen Jialin emphasizes that frequent heavy menstrual bleeding, increased menstrual pain, prolonged periods, or symptoms like dizziness and fatigue due to anemia may be warning signs of adenomyosis. These symptoms should never be ignored or endured in silence. Prompt medical evaluation is essential to determine the most appropriate treatment. Although adenomyosis can affect women of any age, advances in modern technology now allow many high-risk patients to receive safer and more effective care.

2025/08/29