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. 2020 Dec;48(12):300060520976492.
doi: 10.1177/0300060520976492.

Clinical effectiveness and potential long-term benefits of high-intensity focused ultrasound therapy for patients with adenomyosis

Wei Li  1   2 , Jiayu Mao  1   3 , Yang Liu  1 , Ying Zhu  1 , Xiaojing Li  1 , Zhigang Zhang  1 , Xuechai Bai  1 , Wei Zheng  1 , Liang Wang  1
Affiliations

Clinical effectiveness and potential long-term benefits of high-intensity focused ultrasound therapy for patients with adenomyosis

Wei Li et al. J Int Med Res. 2020 Dec.

Abstract

Objectives: Adenomyosis is a common and refractory disease in gynecology. Preserving the uterus during treatment for adenomyosis remains a problem. High-intensity focused ultrasound (HIFU) is widely used in treatment of solid tumors. This study aimed to analyze patients with adenomyosis who were treated by HIFU and to preliminarily examine the characteristics of patients who are more suitable for HIFU to treat adenomyosis with reliable efficacy.

Methods: Over 2 years, 67 women who were diagnosed with adenomyosis and treated with HIFU at our gynecology department were included in this study. We investigated outcomes of their symptoms (dysmenorrhea and hypermenorrhea) and the volume of their uterine lesions. We also compared the patients' clinical profiles.

Results: The women had a mean follow-up duration of 11.6 ± 0.46 months. In the numerical rating scale, used to assess the degree of dysmenorrhea, the score was significantly lower (mean difference: -1.94, 95% confidence interval: -2.704 to -1.176) 3 months after HIFU treatment compared with before treatment, then it remained stable for 3 to 12 months. Hypermenorrhea was reduced to a certain degree, with a mean difference of -0.54 (-1.01-0.02).

Conclusions: HIFU is a new noninvasive treatment method for adenomyosis that may help relieve dysmenorrhea.

Keywords: Adenomyosis; dysmenorrhea; high-intensity focused ultrasound; hypermenorrhea; lesion; uterus.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Flowchart of the study.
Figure 2.
Figure 2.
Effect of HIFU on dysmenorrheal and hypermenorrhea. (a) Box plot showing the changes in the NRS score before and after treatment. (B) Graph showing the effect of the underlying features on NRS. (C) Box plot showing the changes in the FPS before and after treatment. (D) Graph showing the effect of the underlying features of the FPS. *P<0.05, ***P<0.001. NRS, numerical rating scale; FPS, five-point scale; HIFU, high-intensity focused ultrasound; BMI, body mass index.
Figure 3.
Figure 3.
Effect of HIFU on uterine lesion volume. NRS, numerical rating scale; FPS, five-point scale.
Figure 4.
Figure 4.
Effect of Mirena and a GnRHa on the outcome of HIFU for dysmenorrhea and hypermenorrhea. NRS, numerical rating scale; FPS, five-point scale; HIFU, high-intensity focused ultrasound; GnRHa, gonadotropin-releasing hormone agonist.
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