Abstract: Objective To compare the short-term and long-term efficacy of high intensity focused ultrasound (HIFU) and uterine artery embolization (UAE) in the treatment of diffuse and localized adenomyosis. 
Methods A total of 120 patients with adenomyosis who received treatment in the Department of Gynecology, Cangzhou People′s Hospital were selected. The patients were classified into diffuse group (group D, n=60) and limited group (group L, n=60). According to different treatment methods, Groups D and L were divided into subgroups D1, D2 and subgroups L1, L2, respectively. Groups D1 and L1 were treated with HIFU, and groups D2 and L2 were treated with UAE. Symptom severity score (SSS), visual analogue scale (VAS) pain score, Pictorial Blood Loss Assessment Chart (PBAC) score of menstrual volume and health-related quality of life (HRQL) score of each group were recorded and compared before treatment, and at 6 and 12 months after treatment. The uterine volume and lesion volume were evaluated at 12 months after treatment, and the follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), anti-mullerian hormone (AMH) levels and antral follicle (AFC) of the two groups were measured before and at 12 months after treatment. The clinical efficacy of the two groups was calculated for 12 months, they were followed up for 24 months, and the recurrence was recorded. 
Results SSS, VAS pain score and PBAC score of menstrual volume were decreased significantly at 6 and 12 months after treatment in the four groups (P＜0.05), and HRQL score was increased significantly (P＜0.05). However, there was no significant difference among the four groups (P＞0.05). Compared with those before treatment, the uterine volume and lesion volume of the four groups were significantly reduced at 12 months after treatment, showing significant differences (P＜0.05), which were smaller in group D1 than in group D2, as well as in group L1 group than in group L2, suggesting significant differences(P＜0.05). The levels of FSH, LH and E2 in the four groups were significantly lower after treatment, as compared with those before treatment, and significantly lower in group D1 than in group D2 (P＜0.05), while the level of AMH in group D1 was significantly higher than that in group D2 (P＜0.05). The levels of FSH and LH in group L1 were significantly lower than those in group L2, while AMH level was significantly higher than that in group L2 (P＜0.05); however,AFC was not significantly different among the four groups (P＞0.05).There was no significant difference in the total effective rate and recurrence rate among the four groups (P＞0.05). 
Conclusion HIFU is comparable to UAE in short-term and long-term efficacy in the treatment of diffuse and localized adenomyosis. Therefore, the appropriate treatment plan can be selected according to the specific situation. 

Key words: adenomyosis, extracorporeal shockwave therapy, uterine artery embolization