Effects of laparoscopic radiofrequency ablation combined with a levonorgestrel-releasing intrauterine system in patients with adenomyosis

Objective To compare the 12-month clinical outcomes of laparoscopic RFA alone with those of laparoscopic RFA combined with LNG-IUS in patients with symptomatic adenomyosis.

This single-center retrospective cohort study included 70 patients with adenomyosis who had complete 12-month follow-up data. Based on the treatment documented in their medical records, patients were classified into an RFA-alone group (group A, n = 35) and an RFA-plus-LNG-IUS group (group B, n = 35). The primary outcome was the change in VAS score from baseline to 12 months. Continuous outcomes were analyzed using two-way mixed-design repeated-measures analysis of variance, with particular attention to the group-by-time interaction.

Significant group-by-time interactions were observed for VAS score, menstrual volume, and uterine volume at 12 months. Compared with RFA alone, RFA plus LNG-IUS was associated with greater reductions in VAS score (difference in change, − 0.60 points; 95% CI, − 1.06 to − 0.14; P = .012), menstrual volume (− 25.00 mL; 95% CI, − 35.11 to − 14.89; Holm-adjusted P < .001), and uterine volume (− 14.00 cm³; 95% CI, − 17.10 to − 10.90; Holm-adjusted P < .001). At 1 month, the combined-treatment group showed a greater increase in hemoglobin (difference in change, 14.00 g/L; 95% CI, 11.51 to 16.49; Holm-adjusted P < .001) and a greater reduction in CA125 (− 7.10 U/mL; 95% CI, − 11.09 to − 3.11; Holm-adjusted P = .003). No significant group-by-time interactions were observed for white blood cell count, red blood cell count, or platelet count.

In this retrospective cohort, adding LNG-IUS to laparoscopic RFA was associated with greater 12-month improvements in pain, menstrual volume, and uterine volume than laparoscopic RFA alone. These preliminary findings require confirmation in larger prospective studies with longer follow-up. Similar content being viewed by others Abbreviations - VAS: - Visual Analog Scale - LNG-IUS: - Levonorgestrel-releasing intrauterine system - RFA: - Radiofrequency ablation

We thank all patients for providing signed permission to publish this article. Funding This work was supported by the Shanxi Medical Doctor Association Project (YSXH-QL2024ZHZL014). Author information Authors and Affiliations Corresponding authors Ethics declarations Ethics approval and consent to participate The study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of the Shanxi Provincial People’s Hospital (No. 716). The requirement for informed consent was waived by the Ethics Committee because of the retrospective study design. Consent for publication Not applicable. Competing interests 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. Supplementary Information 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 Guo, J., Gao, Y., Xu, L. et al. Effects of laparoscopic radiofrequency ablation combined with a levonorgestrel-releasing intrauterine system in patients with adenomyosis. BMC Women's Health (2026). https://doi.org/10.1186/s12905-026-04947-5 Received: Accepted: Published: DOI: https://doi.org/10.1186/s12905-026-04947-5