Comparative study of female sexual function in adenomyosis patients who received the treatment of intensity-focused ultrasound ablation or laparoscopic total hysterectomy

Zhao X, Xiaoli Zhao, Wei Zhang, Zhang W, Meiyan Mi, Mi M, Haixing Wang, Yiqian Wang, Wang Y, Feng L, Li Feng, Wang H, Hongbin Wang
International Journal of Gynecology & Obstetrics · 2026 · vol. 174(1) , pp. 166–173 · doi:10.1002/ijgo.70824 · PMID:41549913
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

Laparoscopic total hysterectomy (LTH) provided more rapid and sustained pain relief than high-intensity focused ultrasound (HIFU) for adenomyosis patients over 12 months.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This retrospective cohort study compared laparoscopic total hysterectomy (LTH) versus high-intensity focused ultrasound (HIFU) in patients with adenomyosis, assessing pain relief, menstrual blood loss, and female sexual function over 12 months, using propensity score matching to balance age, PBAC, NRS pain scores, and FSFI baseline. After matching, 149 patients were included (LTH n=74, HIFU n=75), and both treatments were associated with significant reductions in pain over time. The LTH group showed more rapid and sustained pain relief, with significantly lower NRS pain scores at 6 and 12 months, while the paper highlights that differences in outcomes support individualized treatment considerations. This paper is centrally about adenomyosis — it directly compares LTH versus HIFU effects on pain and sexual function in adenomyosis patients.

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Abstract

OBJECTIVE: Adenomyosis is a debilitating gynecologic condition. The present study aimed to compare the effects of laparoscopic total hysterectomy (LTH) and high-intensity focused ultrasound (HIFU) on pain relief, menstrual blood loss, and sexual function over a 12-month follow-up period in patients with adenomyosis. METHODS: A retrospective cohort study was conducted at our institution, including patients with adenomyosis who underwent LTH or HIFU. Propensity score matching (PSM) was performed to control for baseline differences in age, pictorial blood loss assessment chart (PBAC) score, numerical rating scale (NRS) for pain, and female sexual function index (FSFI) score, with a caliper value of 0.05. RESULTS: A total of 149 patients were included after PSM (LTH: n = 74, HIFU: n = 75). Both groups demonstrated significant reductions in pain scores over time, but the LTH group exhibited more rapid and sustained pain relief, with NRS scores at 6 months (LTH: 1.92 ± 1.06, HIFU: 3.58 ± 1.32, P < 0.001) and 12 months (LTH: 1.78 ± 1.03, HIFU: 2.94 ± 1.27, P < 0.001). CONCLUSION: LTH and HIFU relieve adenomyosis differently, highlighting the need for personalized treatment based on symptom relief, function, and fertility.
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Abstract

Objective Adenomyosis is a debilitating gynecologic condition. The present study aimed to compare the effects of laparoscopic total hysterectomy (LTH) and high-intensity focused ultrasound (HIFU) on pain relief, menstrual blood loss, and sexual function over a 12-month follow-up period in patients with adenomyosis.

Methods

A retrospective cohort study was conducted at our institution, including patients with adenomyosis who underwent LTH or HIFU. Propensity score matching (PSM) was performed to control for baseline differences in age, pictorial blood loss assessment chart (PBAC) score, numerical rating scale (NRS) for pain, and female sexual function index (FSFI) score, with a caliper value of 0.05.

Results

A total of 149 patients were included after PSM (LTH: n = 74, HIFU: n = 75). Both groups demonstrated significant reductions in pain scores over time, but the LTH group exhibited more rapid and sustained pain relief, with NRS scores at 6 months (LTH: 1.92 ± 1.06, HIFU: 3.58 ± 1.32, P < 0.001) and 12 months (LTH: 1.78 ± 1.03, HIFU: 2.94 ± 1.27, P < 0.001).

Conclusion

LTH and HIFU relieve adenomyosis differently, highlighting the need for personalized treatment based on symptom relief, function, and fertility. CONFLICT OF INTEREST STATEMENT The authors have no relevant financial or non-financial interests to disclose. DATA AVAILABILITY STATEMENT Data will be made available on request.

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Outcome instruments

NRS-pain

Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis

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