Comparative study of female sexual function in adenomyosis patients who received the treatment of intensity‐focused ultrasound ablation or laparoscopic total hysterectomy

OBJECTIVE: Adenomyosis is a debilitating gynecologic condition. The present study aimed to compare the effects of laparoscopic total hysterectomy (LTH) and high-intensity focused ultrasound (HIFU) on pain relief, menstrual blood loss, and sexual function over a 12-month follow-up period in patients with adenomyosis. METHODS: A retrospective cohort study was conducted at our institution, including patients with adenomyosis who underwent LTH or HIFU. Propensity score matching (PSM) was performed to control for baseline differences in age, pictorial blood loss assessment chart (PBAC) score, numerical rating scale (NRS) for pain, and female sexual function index (FSFI) score, with a caliper value of 0.05. RESULTS: A total of 149 patients were included after PSM (LTH: n = 74, HIFU: n = 75). Both groups demonstrated significant reductions in pain scores over time, but the LTH group exhibited more rapid and sustained pain relief, with NRS scores at 6 months (LTH: 1.92 ± 1.06, HIFU: 3.58 ± 1.32, P < 0.001) and 12 months (LTH: 1.78 ± 1.03, HIFU: 2.94 ± 1.27, P < 0.001). CONCLUSION: LTH and HIFU relieve adenomyosis differently, highlighting the need for personalized treatment based on symptom relief, function, and fertility.