Evaluation of the effectiveness of combination therapy utilizing laser-mediated photodynamic therapy in patients with combined hormone-dependent pathology: endometrial hyperplasia and adenomyosis
Serov V.N., Pasman N.M., Selyunina N.A, Veretelnikova T.V., Zhdanova E.A.
Objective. To evaluate the effectiveness of photodynamic therapy (PDT) combined with traditional hormone therapy on reproductive outcomes, the frequency of clinical manifestations, and the recurrence rate in women of reproductive age with endometrial hyperplasia (EH) and adenomyosis.
Materials and methods. A retrospective single-center comparative study was carried out from 2021 to 2023. The sample was formed using a consecutive sampling method. The study included 48 women aged 25 – 45 years with the established diagnosis of adenomyosis based on clinical findings, ultrasound examination, and hysteroscopy, as well as non-atypical EH confirmed by histological examination. Two groups were formed: hormone therapy (n=21) and combination therapy using endometrial PDT (n=27). Assessment of reproductive outcomes included pregnancy rate, the time before getting pregnant, clinical symptoms before and after treatment, and the recurrence rate of EH based on follow-up histology of endometrial biopsy specimens. The follow-up period was up to 36 months.
Results. Combination therapy using PDT led to statistically significant increase in pregnancy rate (p=0.002), whereas the time before getting pregnant did not differ significantly between the groups (p=0.750). Reduced frequency of clinical manifestations after treatment was in both groups. Despite low frequency of abnormal uterine bleeding, heavy menstrual bleeding, and dysmenorrhea in the group of combination therapy using PDT, no statistically significant differences between the groups in these outcomes were observed. The recurrence of EH was less common in the group of women who were treated with combination therapy compared with the group of women who received traditional hormone therapy (3/18 [16.7%] vs 6/13 [46.2%]; RR=0.36; 95% CI 0.11–1.18; p=0.114).
Conclusion. In patients with EH and adenomyosis, combination therapy using PDT was associated with higher pregnancy rate compared with hormone therapy alone. It suggests that this approach is promising for treatment of combined hormone-dependent pathology. The trend was observed in favor of combination therapy with PDT regarding the recurrence rate of EH and persistence of clinical symptoms after treatment. However, no statistically significant intergroup differences were found for these indicators.
Authors' contributions. Selyunina N.A., Veretelnikova T.V., Zhdanova E.A. – patient selection and examination, writing the manuscript, literature review on the topic of the article; Serov V.N., Pasman N.M. – study conception and design, critical review of the content, manuscript approval for publication.
Conflicts of interest. The authors declare that they have no conflicts of interest.
Funding. The study was carried out without any sponsorship.
Ethical Approval. The study was approved by the local Ethics Committee of Novosibirsk National Research State University.
Generative Artificial Intelligence. No generative AI was used in preparing this article.
Patient Consent for Publication. The patients have signed informed consent for publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For sitation: Serov V.N., Pasman N.M., Selyunina N.A, Veretelnikova T.V., Zhdanova E.A. Evaluation of
the effectiveness of combination therapy utilizing laser-mediated photodynamic therapy in patients with combined hormone-dependent pathology: endometrial hyperplasia and adenomyosis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (6): 144-152 (in Russian)
https://dx.doi.org/10.18565/aig.2025.325
Keywords
endometrial hyperplasia
genital endometriosis
adenomyosis
hormonal therapy
combination therapy
endometritis
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Received 10.11.2025
Accepted 30.04.2026
About the Authors
Vladimir N. Serov, Academician of the Russian Academy of Sciences, Dr. Med. Sci., Professor, Chief Researcher, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(495)438-72-87,https://orcid.org/0000-0001-6640-1235
Natalia M. Pasman, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, Institute of Medicine and Medical Technologies, Novosibirsk National Research State University, 630090, Russia, Novosibirsk, Pirogova str., 2, +7(913)916-25-91, https://orcid.org/0000-0002-6095-1954
Nadezhda A. Selyunina, obstetrician-gynecologist, Professor Pasman Clinic LLC; Teaching Assistant, Department of Obstetrics and Gynecology, Institute of Medicine and Medical Technologies, Novosibirsk National Research State University, 630090, Russia, Novosibirsk, Pirogova str., 2, Researcher ID Web of Science: OAJ-2348-2025,
SPIN: 4273-7582, https://orcid.org/0009-0003-9958-6151
Tatyana V. Veretelnikova, obstetrician-gynecologist of the highest category, Professor Pasman Clinic LLC, Russia, Novosibirsk, https://orcid.org/0009-0007-1022-6985
Elizaveta A. Zhdanova, student at the Department of Obstetrics and Gynecology, Institute of Medicine and Medical Technologies, Novosibirsk National Research State University, 630090, Russia, Novosibirsk, Pirogova str., 2, +7(983)406-08-76, e.zhdanova1@g.nsu.ru, SPIN: 8914-4911, https://orcid.org/0009-0001-9259-4840
Corresponding author: Nadezhda A. Selyunina, nadezhda_silk@mail.ru
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