Innovative application of high-intensity focused ultrasound combined with endometrial thermal balloon ablation in the treatment of adenomyosis: A cohort study

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2025-01-30 DOI:10.1016/j.ejogrb.2025.01.049

Zhuoting Jin , Ligang Wang , Dan Wang , Qianwen Zheng , Xuemei Qing , Yong Zhang

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Abstract

Objective

To evaluate the efficacy of high-intensity focused ultrasound (HIFU) combined with endometrial thermal balloon ablation (TBEA) for treating adenomyosis-related hypermenorrhagia.

Methods

This retrospective cohort study included 120 patients diagnosed with adenomyosis-related hypermenorrhagia. Patients were divided into three groups: the HIFU combined with TBEA group (HIFU + TBEA, 34 cases), the HIFU combined with gonadotropin-releasing hormone agonist and intrauterine levonorgestrel intrauterine system (HIFU + GnRH-a + LNG-IUS, 51 cases) group and the HIFU (35 cases) group. Efficacy and safety were assessed using the pictorial blood loss assessment chart (PBAC), dysmenorrhea scores evaluated by the Numerical Rating Scale (NRS), quality of life measured by the Uterine Fibroid Symptom and Quality of Life scale (UFS-QOL), reintervention rates, success rates, satisfaction, and adverse effects at pretreatment and 1, 3, 6, 9, and 12 months posttreatment.

Results

The HIFU + TBEA group showed significantly greater reductions in PBAC scores at 6, 9, and 12 months compared to the HIFU + GnRH-a + LNG-IUS group, and consistently lower scores than the HIFU group at all follow-up points. No significant differences in NRS scores or reintervention rates were observed between groups. Additionally, the HIFU + TBEA group reported higher UFS-QOL scores at 6 and 12 months posttreatment and greater satisfaction at 12 months posttreatment. Its success rate exceeded that of the HIFU group but was comparable to the HIFU + GnRH-a + LNG-IUS group. Serious adverse reactions were rare across all groups.

Conclusion

HIFU combined with TBEA demonstrates good efficacy and safety, providing an effective long-term treatment option for adenomyosis-related hypermenorrhagia in patients without fertility needs.

Synopsis

Evaluating HIFU + TBEA as an effective long-term treatment for adenomyosis-related hypermenorrhagia in patients without fertility needs.

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.