The Effects Of High Intensity Focused Ultrasound Treatment Of Patients With Uterine Fibroids Or Adenomyosis On Pelvic Adhesion

Objective: To investigate the relationship between HIFU treatment of uterine fibroids and adenomyosis and pelvic adhesion of patients, and analyze the related influencing factors to pelvic adhesion.Methods: From November 2010 to March 2015, a total of 1672 patients with uterine fibroids and uterine adenomyosis received hysterectomy, myomectomy or adenomectomy, and cesarean section. Based on the history of HIFU treatment, these patients were divided into HIFU group and non-HIFU treatment group. During surgery, the pelvic adhesion score was recorded following the rules of index score for patients with pelvic adhesion conditions. The related influencing factors of pelvic adhesion were analyzed.Results: No significant difference was observed in baseline characteristics between HIFU group and non-HIFU group(P> 0.05). In the HIFU group the incidence of pelvic adhesion was 45.54%, while the incidence of pelvic adhesion in non-HIFU group was 45.90%. Univariate analysis in the HIFU group showed that the histories of abortion, the number of birth were not related to the pelvic adhesion(P> 0.05). Age, the previous history of endometriosis, the history of surgery, the history of pelvic inflammatory disease, and tumor size were related to pelvic adhesion(P<0.05). The stratified analysis of age and tumor size showed that the lowest rate of pelvic adhesion was found in the group of patients younger than 35 years(P< 0.0167), and the incidence rate of pelvis adhesion was higher in the group of patients with uterine fibroids size larger than 4 cm(P< 0.0167). Furthermore, multivariate analysis showed none of factors was related to pelvic adhesion(P> 0.05). In the non-HIFU group, univariate analysis showed that both abortion and birth were not related to pelvic adhesion; but age, the previous history of endometriosis, the history of surgery, the history of pelvic inflammatory disease, tumor size, and dysmenorrhea were significantly related to pelvic adhesion(P<0.05). We further analyzed and found that the incidence rate of pelvic adhesion was higher in patients older than 35 years, as well as in the group of patients with the size of uterine fibroid was 3.5-4.0 cm(P< 0.0167). Furthermore, multivariate analysis revealed history of surgery and history of pelvic inflammatory disease were related to pelvic adhesion in non-HIFU group.Conclusion: High intensity focused ultrasound treatment for uterine fibroids or adenomyosis is not related to pelvic adhesions. Pelvic adhesion is a result of combination with different factors, in which, surgery and pelvic inflammatory disease are independent factors. Due to HIFU treatment doesn’t result pelvic adhesion, it can be used as preferred treatment for patients with uterine fibroids who had pelvic surgery or inflammatory diseases.