The present adenomyosis treatment status in Luzhou, China: a small scope observational cross-sectional survey.

Abstract

Objective: To evaluate the current treatment status and management deficiencies of adenomyosis in Luzhou, China.

Materials and methods: A small-scale observational cross-sectional study of patients whose imaging suggests adenomyosis from July 2018 to February 2022 at a teaching hospital in Luzhou, China. All participants (1542 patients) completed a questionnaire of 14 items, including basic information, symptoms, treatment options, outcomes, and costs. The patients' treatment options and the hysterectomy rate were evaluated.

Results: The treatment options of hormone agents included combined oral contraceptive pills (COCs), gonadotropin-releasing hormone analogues (GnRH-a), levonorgestrel-releasing intrauterine system (LNG-IUS), and dienogest for 2.07, 46.04, 63.49, and 4.67% of patients, respectively. The treatment options under uterus-sparing surgery included adenomyectomy and high-intensity focused ultrasound (HIFU) treatment, presenting in 3.76 and 33.27% of patients, respectively. Finally, 458 (29.70%) patients chose a hysterectomy. The hysterectomy rate between the hormone and uterus-sparing surgery sequential hormone groups (surgery group) was not significantly different (14.8 vs. 12.7%, χ2 = 0.344, P > 0.05). However, for the focal type and patients with > 24 months delayed treatment interval, the hysterectomy rate of the hormone group was significantly higher than that of the surgery group (8.5% vs. 1.3%, χ2 = 11.722, P < 0.01 and 26.7% vs. 18.5%, χ2 = 4.906, P < 0.05, respectively).

Conclusions: There were treatment delays and treatment selection bias in managing adenomyosis in Luzhou, China. Popular science education and early individualized hormone therapy are needed. Uterine-sparing surgery should be carefully selected.