Synergistic Efficacy and Safety Evaluation of Focused Ultrasound Ablation Surgery Combined with Thermal Balloon Endometrial Ablation in Treating Adenomyosis: A Prospective Controlled Study.

Abstract

Objectives: The objective of this study was to evaluate the synergistic efficacy and safety of focused ultrasound ablation therapy (FUAS) combined with thermal balloon endometrial ablation (TBEA) in treating adenomyosis.

Materials and methods: A total of 103 patients diagnosed with adenomyosis admitted to Nanchuan District People's Hospital of Chongqing from July 2022 to December 2023 were randomized into two groups. The experimental group (n = 36) received FUAS combined with TBEA, whereas the control group (n = 67) underwent FUAS alone. All patients were followed up for 12 months. Clinical symptoms, serological markers, imaging parameters, and adverse events were compared between groups.

Results: At 12 months posttreatment, both groups showed significant improvements in key outcomes. The experimental group exhibited superior outcomes in reducing pictorial blood loss assessment chart scores, improving health-related quality of life scores, lowering CA₁₂₅ levels, and elevating hemoglobin levels compared to the control group (all P < 0.05). No significant differences in follicle-stimulating hormone (FSH) levels were observed between groups. No severe complications occurred.

Conclusion: FUAS combined with TBEA effectively reduces uterine volume, alleviates dysmenorrhea, decreases menstrual flow, improves anemia, and preserves ovarian function (as evidenced by stable FSH levels) with minimal adverse effects. This combined therapy demonstrates enhanced efficacy and safety over monotherapy, providing a promising comprehensive treatment for adenomyosis.