RESULTS: Uterine artery embolization (UAE), radiofrequency ablation (RFA), high-intensity focused ultrasound (HIFU), percutaneous microwave ablation (PMWA), and adenomyomectomy are minimally invasive interventions proven to be effective in reducing AUB and dysmenorrhea due to adenomyosis. Symptom improvement is associated with a decrease in uterine volume. Studies support the use of alternative treatment options given the overall low rates of symptom recurrence and reintervention. Combination therapy may be more effective than monotherapy.
CONCLUSIONS: This review provides the current evidence for use of alternative treatment options for adenomyosis. Access to ablative therapies in the USA is limited and primarily off label, given lack of FDA approval. High-quality prospective and randomized controlled trials are needed in order to further delineate treatment comparisons, efficacy, safety, and ideal patient selection for these treatments. More data are needed to assess safety and utility in those desiring future fertility.
结果:子宫动脉栓塞(UAE),射频消融(RFA),高强度聚焦超声(HIFU),经皮微波消融(PMWA),和腺肌瘤切除术是微创干预措施,被证明可有效减少子宫腺肌病引起的AUB和痛经。症状的改善与子宫体积的减少有关。鉴于症状复发率和再干预的总体较低,研究支持使用替代治疗方案。联合治疗可能比单一治疗更有效。
结论:本综述为子宫腺肌病的替代治疗方案的使用提供了当前的证据。在美国,获得消融疗法的机会有限,而且主要是标签外的,由于缺乏FDA的批准。需要高质量的前瞻性和随机对照试验,以进一步描述治疗比较。功效,安全,和这些治疗的理想患者选择。需要更多的数据来评估那些希望将来生育的人的安全性和实用性。