High-intensity focused ultrasound (HIFU) combined with gonadotropin-releasing hormone analogs (GnRHa) and levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis: a case series with long-term follow up

Sun Hai-yan, Sun Haiyan, Wang Lin, Lin Wang, Shu-Hua Huang, Huang Shuhua, Wei Wang
International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group · 2019 · vol. 36(1) , pp. 1178–1184 · doi:10.1080/02656736.2019.1679892 · PMID:31793356 · W2992349275
article OA: gold CC0 ⤵ 24 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case series evaluated long-term outcomes of high-intensity focused ultrasound combined with GnRHa and LNG-IUS for adenomyosis, finding significant reductions in uterine and lesion volumes, dysmenorrhea, and menstrual bleeding with low recurrence and no serious complications.

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Abstract

Objective: This research was conducted to assess the long-term outcomes of a combination treatment of High-intensity focused ultrasound (HIFU) ablation, gonadotropin-releasing hormone analogs (GnRHa) and Levonorgestrel-releasing intrauterine system (LNG-IUS) for women with adenomyosis (AD).Methods: One hundred and forty-two patients with AD were enrolled and treated with HIFU conservative treatment in combination with adjuvant therapy of GnRHa and LNG-IUS. All the cases were followed up to 5 years after treatment. The volumes of uteri, AD lesions, and menstrual blood, and dysmenorrhea scores were measured. Also, the incidences of recurrence and complications were recorded.Results: Both the uterine and lesion volumes significantly decreased after treatment. The uterine volume gradually reduced after treatment, reaching the lowest level of 122.07 ± 44.12 cm3 at 12 months after treatment, with an average reduction rate of 45%, and then increased slightly, maintaining a reduction rate of about 35% compared with the baseline level. Similar decreases in AD lesion volumes, dysmenorrhea scores, and menstrual flow were also demonstrated. Hemoglobin levels increased. Moreover, the long-term recurrence rates were low, with 5.68% and 7.91% in dysmenorrhea and menorrhagia, respectively. No serious complications or adverse events were reported.Conclusions: HIFU ablation, in combination with GnRHa and LNG-LUS, might be a safe and effective alternative in the treatment for women with adenomyosis.

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Condition tags

adenomyosisdysmenorrhea

MeSH descriptors

Adenomyosis Adenomyosis Gonadotropin-Releasing Hormone High-Intensity Focused Ultrasound Ablation Levonorgestrel Adenomyosis Adult Female Follow-Up Studies Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone High-Intensity Focused Ultrasound Ablation Humans Levonorgestrel Levonorgestrel Middle Aged

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