Is High-intensity Focused Ultrasound Effective for the Treatment of Adenomyosis? A Systematic Review and Meta-analysis

Ana Luiza Santos Marques, Ana Marques, Marina Paula Andres, Rosanne M. Kho, Kho RM, Mauricio Simões Abrão, Maurício Simões Abrão, Abrão MS
Journal of Minimally Invasive Gynecology · 2019 · vol. 27(2) , pp. 332–343 · doi:10.1016/j.jmig.2019.07.029 · PMID:31377454 · W2964767024
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This systematic review and meta-analysis evaluated the efficacy of high-intensity focused ultrasound (HIFU) in treating adenomyosis.

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Abstract

Study objectiveTo systematically review the literature regarding the efficacy of high-intensity focused ultrasound (HIFU) in reducing adenomyotic lesions, patients' pain and bleeding symptoms, and the impact on patients' quality of life.Data sourceA search was performed through PubMed/MEDLINE and Cochrane databases.Methods of study selectionAll available studies published in the English language in the last 10 years that evaluated the effects of HIFU for adenomyosis.Tabulation, integration, and resultsA systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A meta-analysis was performed on data from homogeneous studies. Pooled results from the meta-analysis showed that after HIFU treatment for adenomyosis, a large effect was observed in reducing the uterine volume at 12 months (standard mean difference [SMD] = 0.85), a significant reduction in dysmenorrhea at 3 months (SMD = 1.83) and 12 months (SMD = 2.37), and a significant improvement in quality of life at 6 months (SMD = 3.0) and 12 months (SMD = 2.75). Adverse reactions after HIFU were reported in 55.9% of patients.ConclusionThis review suggests a potential benefit for HIFU in the treatment of adenomyosis-related symptoms; however, findings of the meta-analysis were based on fewer, nonuniform studies, which did not equally account for each specific symptom/parameter across the board. Results showed there appears to be a potential of HIFU in the treatment of adenomyosis-related symptoms. To date, there are no comparative and randomized clinical trials comparing the HIFU technique with other conservative treatment options. As yet, there are insufficient data regarding fertility and pregnancy outcomes.

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Condition tags

dysmenorrheaadenomyosis

MeSH descriptors

Adenomyosis High-Intensity Focused Ultrasound Ablation Adenomyosis Adenomyosis Adenomyosis Adult Dysmenorrhea Dysmenorrhea Dysmenorrhea Female Fertility Fertility High-Intensity Focused Ultrasound Ablation High-Intensity Focused Ultrasound Ablation Humans Pregnancy Pregnancy Outcome Pregnancy Outcome Quality of Life Randomized Controlled Trials as Topic

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (35)

Cited by (38)

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