Comparison of microwave ablation and laparoscopic adenomyomectomy for treating symptomatic uterine adenomyosis: a retrospective study

Yanrong Jin, Weizhi Chen, Chunling Li, Juan Zhao, Yanan Wang, Huan Xiao, Jie Gao
In: European Journal of Medical Research · 2026 · vol. 31(1) · doi:10.1186/s40001-026-04541-3 · W7161017536
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This study found both microwave ablation and laparoscopic adenomyomectomy effectively reduced pain and improved symptoms, with microwave ablation showing advantages for diffuse adenomyosis but a higher recurrence rate for focal lesions compared to laparoscopy.

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Abstract

This study aimed to compare the efficacy and safety of ultrasound-guided percutaneous microwave ablation (PMWA) and laparoscopic adenomyomectomy for the treatment of symptomatic uterine adenomyosis. We conducted a retrospective case–control study of patients with symptomatic adenomyosis treated between January 2019 and December 2021. Visual analog scale (VAS) for pain and adenomyosis symptom severity score (SSS) were assessed before treatment and at 3, 6, and 12 months post-treatment. Uterine volume, lesion volume, hemoglobin (Hb) recovery, recurrence, technical outcomes, and complications were compared between the two groups. Operative parameters and recurrence rates were further analyzed based on adenomyosis type (focal vs. diffuse). A total of 175 patients were included (PMWA: n = 95; Laparoscopy: n = 80). Both treatments significantly reduced VAS and SSS scores, shrunk uterine and lesion volumes, and improved Hb levels at all follow-up points (p < 0.05). For focal adenomyosis, operative time was similar between groups, but PMWA resulted in significantly less intraoperative blood loss and shorter hospital stay (p < 0.05). However, the recurrence rate was higher in the PMWA group (13.2% vs. 0%, p < 0.05). For diffuse adenomyosis, PMWA demonstrated significant advantages over laparoscopy in operative time, blood loss, and hospital stay (all p < 0.05), with no significant difference in recurrence rate. Both PMWA and laparoscopic adenomyomectomy are effective micro-non-invasive treatments for symptomatic adenomyosis. Our findings suggest a stratified treatment approach: laparoscopic adenomyomectomy may be preferable for focal lesions due to lower recurrence, while PMWA offers superior perioperative outcomes for diffuse disease. Individualized treatment selection based on lesion type is recommended.
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Abstract

Objectives This study aimed to compare the efficacy and safety of ultrasound-guided percutaneous microwave ablation (PMWA) and laparoscopic adenomyomectomy for the treatment of symptomatic uterine adenomyosis.

Methods

We conducted a retrospective case–control study of patients with symptomatic adenomyosis treated between January 2019 and December 2021. Visual analog scale (VAS) for pain and adenomyosis symptom severity score (SSS) were assessed before treatment and at 3, 6, and 12 months post-treatment. Uterine volume, lesion volume, hemoglobin (Hb) recovery, recurrence, technical outcomes, and complications were compared between the two groups. Operative parameters and recurrence rates were further analyzed based on adenomyosis type (focal vs. diffuse).

Result

A total of 175 patients were included (PMWA: n = 95; Laparoscopy: n = 80). Both treatments significantly reduced VAS and SSS scores, shrunk uterine and lesion volumes, and improved Hb levels at all follow-up points (p < 0.05). For focal adenomyosis, operative time was similar between groups, but PMWA resulted in significantly less intraoperative blood loss and shorter hospital stay (p < 0.05). However, the recurrence rate was higher in the PMWA group (13.2% vs. 0%, p < 0.05). For diffuse adenomyosis, PMWA demonstrated significant advantages over laparoscopy in operative time, blood loss, and hospital stay (all p < 0.05), with no significant difference in recurrence rate.

Conclusion

Both PMWA and laparoscopic adenomyomectomy are effective micro-non-invasive treatments for symptomatic adenomyosis. Our findings suggest a stratified treatment approach: laparoscopic adenomyomectomy may be preferable for focal lesions due to lower recurrence, while PMWA offers superior perioperative outcomes for diffuse disease. Individualized treatment selection based on lesion type is recommended. Similar content being viewed by others

Acknowledgements

Not applicable. Funding This study was not funded by anything. Author information Authors and Affiliations Corresponding authors Ethics declarations Ethics approval and consent to participate This study was approved by the Ethics Committee of Beijing Luhe Hospital, Capital Medical University. All methods were carried out in accordance with Declaration of Helsinki. Consent for publication All the authors have confirmed that the subjects' consent for publication has been obtained. Clinical trial number Not applicable. Competing interest The authors declare no competing interests. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. About this article Cite this article Jin, Y., Chen, W., Li, C. et al. Comparison of microwave ablation and laparoscopic adenomyomectomy for treating symptomatic uterine adenomyosis: a retrospective study. Eur J Med Res (2026). https://doi.org/10.1186/s40001-026-04541-3 Received: Accepted: Published: DOI: https://doi.org/10.1186/s40001-026-04541-3

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Outcome instruments

VAS-pain

Condition tags

adenomyosis

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