Safety And Efficacy Of High Intensity Focused Ultrasound In Treatment Of Gaint Uterine Fibroids

Uterine fibroids are common gynecologic benign tumors, the pathogenesis is unclear. Uterine fibroids are most frequently seen during30-50 years old. Uterine fibroids often cause menstrual disorders,lumbosacral pain, infertility, abortion, frequent urination, constipation etc.When fibroid volume is larger,the above symptoms become more pronounced,thus cause a serious adverse impact on women’s health and quality of life. Clinically,fibroids which have a maximum diameter ≥7.0cm are commonly refferred to as giant uterine fibroids. Mainly because patients did not receive correct diagnosis and treatment in time, especially in the remote areas. Traditional treatment methods are mostly myomatectomy or hysterectomy surgery.In recent years due to the popularity of minimally-invasive and non-invasive treatment concept,HIFU,as a noninvasive treatment, has been widely used in clinical treatment of uterine fibroids. Numerous studies have been reports haveconfirmed the efficacy and safety HIFU treatment of uterine fibroids.However, HIFU in the treatment of GUF study still needs to be more specific. Studies have reported the ablation rate was low when the tumor size was larger, but others think that the diameter of the tumor was not related to the therapeutic effect of HIFU.This study analyzed HIFU treatme-nt in patients with GUF in recent years to evaluate the clinical value of HIFU treatment.Objective : To investigate the safety and effectiveness of HIFU in treatment of giant uterine fibroids to provide evidence for its clinical rational treatment.Method : Totally 50 patients with 52 GUF were treated with HIFU in Chongqing Haifu Hospital From June 2011 to May 2015 were selected,with maximum diameter was 8.8±1.8cm(7.0-15.0)cm,the volume was 263.8±161.7cm3(96.6-748.3)cm3.The enhanced MRI was re-examined on 1 d after treatment for measuring and calculating the fibroids ablation rate. Follow-up was performed for 6 mouths after treatment.The tumor size was compared before and after treatment and the incidence of adverse effects,including radiating pain of lower limbs and vaginal abnormal discharge was recorded and statistics analysis was performed.The treatment adverse reactions were evaluated to the criteria of the SIR,the effectiveness and safety of treatment were evaluated.Result : Total 52 gaint uterine fibroids in 50 cases smoothly receivedthe HIFU,grey scale change was observed during treatment.The postoperative ablation rate was(77.8±14.9)%.No difference was obversed in the ablation rate of giant uterine leiomyoma with different kinds and growth positions.The tumor volume was smaller after treatment than before treatment by 6-month follow up with the shrinkage rate of(59.6±20.8)%,the effective rate of treatment was 69.2%(36/52),the difference was statistically significant(P<0.05).The clinical symptoms were improved in different degrees,The total improvement rate was 86.8%(33/38);Adverse effects were SIR A-B,no serious complications occurred. SIR A including lower abdomen, coccydynia(15), vaginal bleeding(17), urinary pain(1),SIR B including sciatica(5),urinary retention(1).The incidence of adverse reaction was 52%(26/50).Conclusion : HIFU is a safe and effective for the treatment of GUF,and can be used as one of the treatment methods in clinic.