conservative fertility-preserving surgery in a woman with huge adenomyosis using triple flap technique and mirena: a case report

Background and objective: being considered a common benign uterine disorder, adenomyosis (ad) is defined as the presence of an endometrial gland and stroma within the myometrium. it causes symptoms such as dysmenorrhea, menorrhagia, chronic pelvic pain, and infertility. it has a step-by-step treatment, initiating with medical therapy, conservative surgery, and finally, the hysterectomy. as some of the women with adenomyosis are nulligravid and want to become pregnant later, most patients prefer fertility-preserving surgery.case report: this study describes the management of diffuse posterior ad in a 36-year-old virgin female by triple flap technique and levonorgestrel intrauterine device (lng-iud) insertion during operation to prevent future recurrence and reduction of patient’s symptoms. the application of the triple flap technique and lng-iud in this patient was associated with excellent results.conclusion: the wide excision of the lesion leads to symptom improvement, especially hypermenorrhea and dysmenorrhea; besides, the reconstruction of the uterine wall with this technique increases the risk of the possibility of future pregnancy for our patient.