Choosing between USgHIFU and hysterectomy for adenomyosis treatment.

Hysterectomy vs. HIFU for Adenomyosis: Weighing the Costs and Benefits

Kai Mendoza in Health & Wellness September 2025 • 5 min read.

"A comprehensive look at ultrasound-guided high-intensity focused ultrasound (USgHIFU) and hysterectomy, helping you make an informed decision about adenomyosis treatment."

Adenomyosis, a condition where the uterine lining grows into the muscular wall of the uterus, affects many women, particularly those of reproductive age. While the exact prevalence is hard to pin down, studies suggest it could impact anywhere from 8.8% to 31% of women. This often leads to chronic pelvic pain, heavy bleeding, and a significant impact on quality of life.

Traditionally, hysterectomy – surgical removal of the uterus – has been considered the definitive solution for adenomyosis. However, it's a major procedure with potential side effects and isn't suitable for women who still desire to have children. Other options like hormonal therapies exist, but their effectiveness can be limited by side effects and the chance of symptoms returning.

Enter ultrasound-guided high-intensity focused ultrasound (USgHIFU), a non-invasive treatment that's gaining traction. USgHIFU uses focused sound waves to heat and destroy the adenomyotic tissue, offering a potential alternative to surgery. But how does it truly stack up against hysterectomy, especially when considering costs and overall quality of life? That's precisely what a recent study aimed to find out.

USgHIFU vs. Hysterectomy: What the Research Shows

Choosing between USgHIFU and hysterectomy for adenomyosis treatment.

A retrospective study published in the BJOG: An International Journal of Obstetrics and Gynaecology compared the outcomes of USgHIFU and hysterectomy for women with symptomatic adenomyosis. The study, conducted at a single center in China, involved 368 patients: 302 treated with USgHIFU and 66 undergoing hysterectomy. Researchers followed these women for a year, tracking their quality of life (QOL) and costs associated with each treatment.

Here's a breakdown of the key findings:

Quality of Life: Both USgHIFU and hysterectomy significantly improved patients' quality of life after treatment. Interestingly, there was no significant difference in QOL between the two groups at any point during the one-year follow-up.
Cost-Effectiveness: This is where USgHIFU shined. The study found that the quality-adjusted life year (QALY) – a measure of both the quality and quantity of life gained from a treatment – was significantly less expensive with USgHIFU (US$5256.48) compared to hysterectomy (US$7510.03). Both incremental cost and sensitivity analyses confirmed that USgHIFU was the more cost-effective option.
Symptom Relief: USgHIFU effectively reduced menstrual volume, shortened menstrual periods, and lessened dysmenorrhea (painful periods). The size of the adenomyotic lesions also decreased after USgHIFU treatment.
Adverse Events: USgHIFU was associated with minor side effects like leg pain, sciatic pain, and temporary skin sensations. Hysterectomy patients, on the other hand, experienced post-surgical pain and discomfort.

In essence, the study suggests that USgHIFU offers a comparable improvement in quality of life to hysterectomy for adenomyosis, but at a significantly lower cost. It's important to note that this study was conducted at a single center and further research may be needed to confirm these findings in other populations.

Making the Right Choice for You

Ultimately, the decision between USgHIFU and hysterectomy for adenomyosis is a personal one. Factors to consider include the severity of your symptoms, your desire for future pregnancies, your tolerance for potential side effects, and, as this study highlights, the cost. Discuss all your options with your doctor to determine the best course of treatment for your individual needs and circumstances. This research provides valuable insights into the cost-effectiveness of USgHIFU, but it's just one piece of the puzzle. A shared decision-making approach, where you and your healthcare provider weigh the pros and cons of each option together, is key to achieving the best possible outcome and improving your quality of life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/1471-0528.14746, Alternate LINK

Title: A Comparison Of The Cost-Utility Of Ultrasound-Guided High-Intensity Focused Ultrasound And Hysterectomy For Adenomyosis: A Retrospective Study

Subject: Obstetrics and Gynecology

Journal: BJOG: An International Journal of Obstetrics & Gynaecology

Publisher: Wiley

Authors: Xf Liu, Lh Huang, C Zhang, Gh Huang, Lm Yan, J He

Published: 2017-08-01

Everything You Need To Know

What is adenomyosis, and how does it typically impact women's lives?

Adenomyosis is a condition where the uterine lining grows into the muscular wall of the uterus. This often leads to chronic pelvic pain and heavy bleeding, significantly impacting a woman's quality of life. While the exact prevalence varies, studies suggest it affects between 8.8% and 31% of women, particularly those of reproductive age. Traditional treatments have included hysterectomy and hormonal therapies, but these have limitations and potential side effects. Ultrasound-guided high-intensity focused ultrasound (USgHIFU) is emerging as a non-invasive alternative that directly targets the adenomyotic tissue.

What are the key differences between undergoing a hysterectomy and USgHIFU for treating adenomyosis, especially considering future pregnancies?

Hysterectomy involves the surgical removal of the uterus, which is a definitive solution for adenomyosis but unsuitable for women who desire future pregnancies. It also carries potential surgical side effects and a longer recovery. In contrast, USgHIFU is a non-invasive treatment that uses focused sound waves to heat and destroy adenomyotic tissue, preserving the uterus and potentially allowing for future pregnancies. However, it's important to consider that while USgHIFU preserves the uterus, its long-term effects on fertility aren't yet fully understood. The recent retrospective study provides insights into the quality of life and cost-effectiveness aspects of both treatments.

How does ultrasound-guided high-intensity focused ultrasound (USgHIFU) work to treat adenomyosis?

Ultrasound-guided high-intensity focused ultrasound (USgHIFU) is a non-invasive treatment that uses focused sound waves to generate heat and precisely target and destroy adenomyotic tissue within the uterus. The ultrasound guidance ensures accuracy, minimizing damage to surrounding healthy tissue. By ablating the problematic tissue, USgHIFU aims to reduce menstrual volume, shorten menstrual periods, and lessen dysmenorrhea (painful periods). This approach differs significantly from a hysterectomy, which involves the surgical removal of the entire uterus.

According to the research, how do the costs of USgHIFU compare to the costs associated with a hysterectomy for adenomyosis treatment?

A retrospective study published in the *BJOG: An International Journal of Obstetrics and Gynaecology* found that ultrasound-guided high-intensity focused ultrasound (USgHIFU) was significantly more cost-effective than hysterectomy for treating adenomyosis. The quality-adjusted life year (QALY) was less expensive with USgHIFU (US$5256.48) compared to hysterectomy (US$7510.03). This suggests that while both treatments can improve quality of life, USgHIFU offers a more economical option. This cost-effectiveness should be weighed alongside other factors like the desire for future pregnancies and potential side effects when making a treatment decision.

What kind of side effects or adverse events are typically associated with USgHIFU compared to hysterectomy?

Ultrasound-guided high-intensity focused ultrasound (USgHIFU) is generally associated with minor side effects such as leg pain, sciatic pain, and temporary skin sensations. These side effects are typically less severe and of shorter duration compared to those associated with a hysterectomy. Hysterectomy patients may experience post-surgical pain, discomfort, and a longer recovery period, reflecting the invasive nature of the procedure. The study highlighted these differences, with USgHIFU demonstrating a more favorable side effect profile in the short term. Long-term side effects for either treatment were not extensively covered in the study.