Combined therapeutic effects of HIFU, GnRH-a and LNG-IUS for the treatment of severe adenomyosis

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AI-generated summary by claude@2026-06, 2026-06-09

This study investigated the combined efficacy of HIFU, GnRH-a, and LNG-IUS for severe adenomyosis, finding significant relief from dysmenorrhea and menorrhagia, uterine shrinkage, and normalized CA-125 levels.

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Abstract

OBJECTIVE: To evaluate the combined efficacy of high-intensity focused ultrasound (HIFU), gonadotropin-releasing hormone agonist (GnRH-a) and the levonorgestrel-releasing intrauterine system (LNG-IUS) for the treatment of severe adenomyosis. METHOD: Four hundred and sixty-six patients with adenomyosis admitted to the Department of Gynecology of Shanghai First Maternity and Infant Hospital underwent HIFU treatment, and then were consecutively administered with GnRH-a 1 d, 1 month and 3 months after HIFU treatment. The uterine size was then measured with ultrasound or MRI 2-4 weeks after three cycles of GnRH-a injection. The LNG-IUS was then inserted when the uterine length less than 9 cm. The visual analog scale (VAS), verbal rating scale (VRS), menstrual volume score, uterus volume, MRI, serum levels of hemoglobin and CA125 were measured at pre and 3-, 6-, 12-month post-HIFU. RESULTS: Dysmenorrhea and menorrhagia significantly relieved after combined treatment with HIFU, GnRH-a and the LNS-IUS. The uterine volume shrank and returned to its normal size. The serum CA-125 level was reduced to the normal level after the combined treatment. CONCLUSIONS: The combined therapeutic regimen of HIFU, GnRH-a and LNS-IUS is safe, effective and efficient for curing severe adenomyosis.

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Outcome instruments

VAS-pain

Condition tags

adenomyosisdysmenorrhea

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Extracorporeal Shockwave Therapy Gonadotropin-Releasing Hormone Levonorgestrel Extracorporeal Shockwave Therapy Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Levonorgestrel Levonorgestrel

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Cited by (34)

Source provenance

europepmc
last seen: 2026-06-11T06:19:48.454388+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:22:48.502547+00:00
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