Comparison of the treatment efficacies of HIFU, HIFU combined with GnRH-a, and HIFU combined with GnRH-a and LNG-IUS for adenomyosis: A systematic review and meta-analysis

AbstractTo compare the treatment efficacies of high-intensity focused ultrasound (HIFU), HIFU combined with gonadotrophin-releasing hormone agonist (GnRH-a), and HIFU combined with GnRH-a and levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis. We conducted a literature search in...

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Vydáno v:Taiwanese journal of obstetrics & gynecology Ročník 62; číslo 2; s. 226 - 238
Hlavní autoři: Otgontuya, Altangerel, Jeng, Cherng-Jye, Wu, Trong-Neng, Chuang, Linus T, Shen, Jenta
Médium: Journal Article
Jazyk:angličtina
Vydáno: China (Republic : 1949- ) Elsevier B.V 01.03.2023
Elsevier
Témata:
Adenomyosis
Adenomyosis - surgery
Dysmenorrhea - therapy
Efficiency
Female
GnRH-a
Gonadotropin-Releasing Hormone
HIFU
Humans
Internal Medicine
Intrauterine Devices, Medicated
Levonorgestrel - therapeutic use
LNG-IUS
Obstetrics and Gynecology
Treatment
Treatment Outcome
HIFU
Treatment
Efficiency
GnRH-a
Adenomyosis
LNG-IUS
ISSN:1028-4559, 1875-6263, 1875-6263
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Shrnutí:AbstractTo compare the treatment efficacies of high-intensity focused ultrasound (HIFU), HIFU combined with gonadotrophin-releasing hormone agonist (GnRH-a), and HIFU combined with GnRH-a and levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis. We conducted a literature search in SCIENCE DIRECT, COCHRANE LIBRARY, WILLEY ONLINE LIBRARY, PUBMED, and TAYLOR FRANCIS. A total of 471 articles identified, 12 were included in a systematic review, and 11 of them deemed quantitively eligible included in the meta-analysis. The efficacies of the three treatment regimens were assessed using the dysmenorrhea and menstrual scores at 3, 6, 12, 24 months. Of the three regimens, HIFU combined with GnRH-a and LNG-IUS provides the best outcome. On dysmenorrhea score at 6 months there was significantly different higher heterogeneity with P < 0.00001 (I 2 = 100% WMD 21.44 [6.34, 36.53]) with statistical significance P = 0.005. At 12 months there was significantly different higher heterogeneity P < 0.00001 (I 2 = 100% WMD 23.47 [6.00, 40.94]) with statistically significant P < 0.008. At 24 months there was significantly different higher heterogeneity P < 0.0005 (I 2 = 92% WMD 6.05 [4.81, 7.30]) with statistical significance P < 0.00001. HIFU combined with GnRH-a and LNG-IUS on menstrual score at 3 months was significantly different higher heterogeneity with P < 0.00001 (I 2 = 100% WMD 56.23 [16.01, 96.45]) with statistical significance P = 0.006. At 6 months there was significantly different higher heterogeneity P < 0.00001 (I 2 = 99% WMD 93.86 [64.15, 123.57]) with statistical significance P < 0.00001. At 12 months there was significantly different higher heterogeneity P < 0.00001 (I 2 = 99% WMD 97.13 [67.81, 126.46]) with statistical significance P < 0.00001 compared to treatments with only HIFU and HIFU combined with GnRH-a. HIFU combined with GnRH-a and LNG-IUS treatment is more effective than only HIFU monotherapy and HIFU combined with GnRH-a.
Bibliografie:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
ObjectType-Review-4
content type line 23
ObjectType-Undefined-3
ISSN:1028-4559
1875-6263
1875-6263
DOI:10.1016/j.tjog.2022.11.009