HIFU therapy Review of current status.

INTRODUCTION \n In recent years, HIFU therapy has become a viable surgical alternative for patients who still wish to have their uterus. However, adenomyosis is a disease that is very sensitive to the estrogen hormone, and HIFU therapy will not change the performance of hormones in the body. The risk of recurrence still exists.GnRH-A is a hormone that is commonly used for the treatment of adenomyosis, which can lower estrogen levels to menopausal levels and increase adenomyotic atrophylesia in the myometrium.This study provides several systematic reviews and meta-analyses of HIFU combined with GnRH-A in adenomyosis and provides proof-based medical evidence for clinical applications \nDISCUSSION \nThe results of this meta-analysis data from 766 patients showed that, HIFU combined with GnRH-a compared to HIFU group, for the treatment of adenomyosis had greater effectiveness in reducing uterine volume and adenomiotic lesions and alleviating symptoms.The therapeutic mechanism of HIFU produces thermal and cavitation effects which are altered by the mechanical effects of ultrasound causing the target tissue temperature at the focal point to rise above 60–100◦C, causing non-coagulation necrosis lesions. At the same time, the surrounding structures are not damaged. HIFU treatment was an effective and ideal treatment for adenomyosis. Studies have shown that HIFU is a safe and effective procedure for infertile women and it does not increase obstetric risk. \nRESULTS \nOf the 390 articles, 9 studies were obtained from data of 766 patients analyzed in this meta-analysis. Of the nine studies, one of them was using MRI for the imaging diagnosis of adenomyosis, six were using transvaginal ultrasound or MRI, and the three ones did not report specific imaging diagnostic methods. Although these studies provide information about the diagnostic imaging methods used, they do not provide specific imaging criteria for the diagnosis of adenoma. \nCONCLUSION \nThe results of this meta-analysis show that compared with mere HIFU treatment and HIFU accompanied by GnRH-a therapy performed on adenomyosis, obtained a greater level of effectiveness in reducing uterine volume and adenomyotic lesions and alleviating symptoms. However, because the number of studies included is too small, further research that has a long-term evaluation is needed. \nKey words: HIFU (High Intensity Focus Ultrasound), ultrasound-guided HIFU (USgHIFU), Adenomyosis, Infertility, GnRHa,