High Intensity Focused Ultrasound Combined With Levonorgestrel-Releasing Intrauterine System In Treatment Of Diffuse Adenomyosis

Objective:To retrospectively evaluate the effect of high-intensity focused ultrasound (HIFU) combined with levonorgestrel-releasing intrauterine system (LNG-IUS) for diffuse adenomyosis.Methods:Between January and October 2014,41 patients with diffuse adenomyosis were treated by HIFU ablation in the third Xiangya hospital of Hunan Province. ING-IUS was placed in 17 patients at 3 months after HIFU treatment in the outpatient department, and the rest 24 patients only treated HIFU ablation. The menorrhagia severity score, the menstruation severity score, size of the uterus were evaluated before and after HIFU treatment at 1-,3-, and 6-month, respectively. The adverse effects and complications were recorded.Results:For all the patients, the menorrhagia severity score and the menstruation severity score at 1-,3-, and 6-month after HIFU were significantly lower than that before HIFU treatment (P<0.05). The volume of uterus at 3-,6-month after HIFU was significantly smaller than that before HIFU (P<0.05). At post-HIFU 6 months, the menorrhagia severity score and the menstruation severity score in the group of patients using LNG-IUS were significantly lower than that of patients treated with HIFU alone (P<0.05). No any other significantly difference was observed between the two groups. No HIFU related complications occurred in the two groups.Conclusion:1. HIFU is safe and effective for in treating diffuse adenomyosis.2. Based on our the short-term results with small number of patients, HIFU combined with LNG-IUS may help patients to get better symptom relief than HIFU treatment alone, with few side effects.