High-Intensity Focused Ultrasound Combined With Gonadotropin-Releasing Hormone Agonist or Levonorgestrel-Releasing Intrauterine System in Treating Dysmenorrhea of Severe Adenomyosis

Yaping Xu, Xu Y, Zhou Z, Zhan Zhou, Wang H, Haili Wang, Shao L, Lin Shao, Guoyan Liu, Liu G
Journal of computer assisted tomography · 2021 · vol. 45(2) , pp. 224–231 · doi:10.1097/rct.0000000000001138 · PMID:33661158 · W3135348756
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High-intensity focused ultrasound combined with a levonorgestrel-releasing intrauterine system demonstrated improved long-term dysmenorrhea relief in severe adenomyosis patients compared to HIFU alone or with a gonadotropin-releasing hormone agonist.

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Abstract

OBJECTIVE: The objective of this study was to investigate the efficacy of high-intensity focused ultrasound (HIFU) combined with gonadotropin-releasing hormone agonist or levonorgestrel-releasing intrauterine system (LNG-IUS) in treating dysmenorrhea in patients with severe adenomyosis. METHODS: A retrospective analysis was performed on 243 patients diagnosed with severe adenomyosis. Patients were divided into H (received HIFU alone), H-G (received HIFU combined with gonadotropin-releasing hormone agonist), and H-L (received HIFU combined with LNG-IUS) groups. Their clinical results were compared at 3 months, 6 months, and 12 months after treatment. RESULTS: The effective rates of dysmenorrhea relief in the 3 groups after 3 months were 95.24% in the H group, 98.8% in the H-G group, and 94.74% in the H-L group; those after 6 months were 88.10% in the H group, 95.18% in the H-G group, and 84.21% in the H-L group; those after 12 months were 77.38% in the H group, 79.52% in the H-G group, and 96.05% in the H-L group. There was significant difference in effective rates of dysmenorrhea relief among 3 groups after 12 months of treatment, but not 3 or 6 months. In addition, at 12 months after treatment, there were significant differences in the efficacy of dysmenorrhea between patients of different ages or different ablation rates in group H. However, there was no significant difference in the H-G group and the H-L group. CONCLUSIONS: High-intensity focused ultrasound alone is effective in alleviating the symptoms of dysmenorrhea in short term. However, HIFU combined with LNG-IUS improves the therapeutic effect for a longer period.

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Condition tags

dysmenorrheaadenomyosis

MeSH descriptors

Adenomyosis Dysmenorrhea Extracorporeal Shockwave Therapy Extracorporeal Shockwave Therapy Gonadotropin-Releasing Hormone Levonorgestrel Adenomyosis Adenomyosis Adenomyosis Adult Adult Dysmenorrhea Dysmenorrhea Dysmenorrhea Female Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Hormones Hormones

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References (24)

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