Uterus-sparing surgery vs hysterectomy for adenomyosis: how chosen?

Specialists usually choose between uterus-sparing surgery and hysterectomy for adenomyosis based on how severe your symptoms are, what you want for future fertility, and what imaging suggests about the pattern of disease. Age and how strongly symptoms are affecting daily life also matter, because adenomyosis can behave very differently from person to person.

In general, focal adenomyosis (a more localized area) may be a better fit for targeted removal of the adenomyosis while preserving the uterus, while diffuse adenomyosis (more widespread involvement) can be harder to fully remove and more likely to persist or recur after conservative surgery. When symptoms are severe and disease is extensive, hysterectomy may offer the most definitive uterine-source symptom relief, but it’s not automatically the right next step for everyone. In a consultation, our team reviews your history, goals, and imaging to lay out realistic options and expected tradeoffs so you can make an informed decision.