High-intensity focused ultrasound in the management of adenomyosis: long-term results from a single center

Li, Xilei; Zhu, Xiaogang; He, Songlin; Jiang, Zhaoying; Li, Huihua; Tian, Xingbo; Long, Wenxin; Xue, Min; Deng, Xingming; Ye, Mingzhu

doi:10.1080/02656736.2021.1886347

Cited by 34 publications

(29 citation statements)

References 19 publications

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“…Levgur et al proposed that menorrhagia is related to the depth of adenomyotic lesion in the myometrium (31). A long-term results from single center proposed that HIFU had poor long-term efficacy for adenomyosis (32). The results of this retrospective analysis showed a significant effect in decreasing the dysmenorrhea score and the menorrhagia score at each follow-up time point.…”

Section: Discussionmentioning

confidence: 70%

Efficacy of High-Intensity Focused Ultrasound Combined With GnRH-a for Adenomyosis: A Systematic Review and Meta-Analysis

Pang

Jin

Fan

et al. 2021

Front. Public Health

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Objective: High-intensity focused ultrasound (HIFU) is an innovative non-invasive technology used for adenomyosis. Gonadotropin-releasing hormone agonist (GnRH-a) is a hormone commonly used for adenomyosis. We investigated and assessed the efficacy of HIFU combined with GnRH-a for adenomyosis.Methods: For this systematic review and meta-analysis, we searched Pubmed, Cochrane Library, Web of Science, Embase, CNKI, WanFang, and VIP databases for relevant articles published in Chinese or English that compared HIFU combined with GnRH-a vs. HIFU alone in patients with adenomyosis. The last literature search was completed on January 31, 2021. Two reviewers independently assessed study eligibility and assessed risk of bias. Another two reviewers extracted the data. The RevMan5.3 software was used for the data analysis. Changes in volume of the uterine and adenomyotic lesion were defined as the primary outcomes. The secondary outcomes were visual analog scale (VAS) scores for dysmenorrhea, menstrual volume scores, serum CA125 levels, and recurrence rate. This study is registered with PROSPERO (CRD42021234301).Results: Three hundred and ninety potentially relevant articles were screened. Nine studies with data for 766 patients were finally included. Compared with the HIFU alone group, the HIFU combined with GnRH-a group had a higher rate of uterine volume reduction (MD 7.51, 95% CI 5.84–9.17, p < 0.00001), smaller adenomyotic lesion volume (MD 4.11, 95% CI 2.93–5.30, p < 0.00001), lower VAS score for dysmenorrhea (MD 1.27, 95% CI 0.54–2.01, p = 0.0007) and menstrual volume score (MD 0.88, 95% CI 0.73–1.04, p < 0.00001), and lower CA125 level (SMD 0.31, 95% CI 0.05–0.56, p = 0.02) after the procedure. The recurrence rate in the HIFU combined with GnRH-a group was lower than that in the HIFU alone group (RR 0.28, 95% CI 0.10–0.82, p = 0.02).Conclusions: Compared with HIFU treatment alone, HIFU combined with GnRH-a for the treatment of adenomyosis has greater efficacy in decreasing the volumes of the uterine and adenomyotic lesions and alleviating symptoms. However, since the number of the included studies was too small and most of them were written in Chinese, this conclusion needs to be referenced with caution. And the long-term evidence of its efficacy is still insufficient.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/ identifier [CRD42021234].

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Section: Discussionmentioning

confidence: 70%

Efficacy of High-Intensity Focused Ultrasound Combined With GnRH-a for Adenomyosis: A Systematic Review and Meta-Analysis

Pang

Jin

Fan

et al. 2021

Front. Public Health

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“…Uterine and adenomyotic volume, dysmenorrhea, and menorrhagia all significantly decreased upon addition of GnRH after HIFU treatment ( p < 0.05) [ 91 ]. Similar results were seen when HIFU was combined with LNG-IUD and long-term efficacy also seemed to be enhanced in the combined treatment such that the 6 months and 3 years follow up results were significantly higher in groups treated with combination therapy than with HIFU alone [ 92 , 93 ].…”

Section: Resltsmentioning

confidence: 61%

Current and Prospective Treatment of Adenomyosis

Sharara

Kheil

Féki

et al. 2021

JCM

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(1) Background: Adenomyosis is a poorly understood entity which makes it difficult to standardize treatment. In this paper we review and compare the currently approved medical and surgical treatments of adenomyosis and present the evidence behind them. (2) Methods: A PubMed search was conducted to identify papers related to the different treatments of adenomyosis. The search was limited to the English language. Articles were divided into medical and surgical treatments. (3) Results: Several treatment options have been studied and were found to be effective in the treatment of adenomyosis. (4) Conclusions: Further randomized controlled trials are needed to compare treatment modalities and establish a uniform treatment algorithm for adenomyosis.

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“…*Kwok To Thomas HIFU ablation, also known as focused ultrasound surgery (FUS), is the latest advancement in treating many benign solid tumours in gynaecology and surgical conditions, 10-14 including, but not limited to, uterine fibroids and adenomyosis. 12,[15][16][17] It is non-invasive, in which the most striking feature is no cut wound of the uterine wall in which the lesions are located.…”

Section: Authorsmentioning

confidence: 99%

Fertility and Pregnancy Outcomes after High-Intensity Focused Ultrasound Ablation for Uterine Fibroids and Adenomyosis: A Review

Wong

2022

EMJ Innov

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High-intensity focused ultrasound (HIFU) ablation, also known as focused ultrasound surgery, is the latest advancement in treating uterine fibroids and adenomyosis. Limited evidence, in terms of case series only, suggest that ultrasound-guided focused ultrasound/magnetic resonance-guided focused ultrasound treatment for fibroids and adenomyosis could be a safe alternative to myomectomy or uterine artery embolisation for females who wish to have babies. It also appears that this non-invasive HIFU treatment can shorten the treatment to pregnancy interval after HIFU ablation. Further studies are needed to confirm such findings.

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High-intensity focused ultrasound in the management of adenomyosis: long-term results from a single center

Cited by 34 publications

References 19 publications

Efficacy of High-Intensity Focused Ultrasound Combined With GnRH-a for Adenomyosis: A Systematic Review and Meta-Analysis

Efficacy of High-Intensity Focused Ultrasound Combined With GnRH-a for Adenomyosis: A Systematic Review and Meta-Analysis

Current and Prospective Treatment of Adenomyosis

Fertility and Pregnancy Outcomes after High-Intensity Focused Ultrasound Ablation for Uterine Fibroids and Adenomyosis: A Review

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