Radiofrequency Endometrial Ablation or Uterine Artery Embolization for Treatment of Adenomyosis-related Abnormal Uterine Bleeding

Inclusion Criteria: * Premenopausal women aged 30 to 50 years * Women who had at least 3 prior months failed medical therapy, or a contraindication to medical therapy, or refused medical therapy for adenomyosis-related AUB * Symptomatic pure internal adenomyosis or dominant adenomyosis (with less than 5 concurrent uterine fibroids type 3-7 \< 5 cm) confirmed by MRI (\< 6 months) according to ESHRE criteria * AUB defined as a PBAC score \>100 at baseline * Uterine ultrasound measurement of 6.0-12.0 cm (external os to internal fundus) * Women with an indication for hysterectomy for adenomyosis-related AUB and accepting hysterectomy * Highly effective contraception for women of childbearing potential, maintained until the onset of menopause * Affiliated or beneficiary of health insurance * Signed informed consent Exclusion Criteria: * Uterine cavity abnormality or obstruction confirmed via imaging modalities or hysteroscopy * Deep infiltrating posterior subperitoneal endometriosis involving contiguous digestive tract structures * Uterine malignancy within the last five years * Secreting ovarian tumor * Atypical endometrial hyperplasia * Unaddressed high grade cervical intra-epithelial lesions * Active sexually transmitted disease or pelvic inflammatory disease * Documented or suspected coagulopathies or long-term blood-thinner medications * Prior transmural myomectomy or prior endometrial ablation * Plasma FSH level \> 40 IU/mL * Any contraindication to angiography (including…