Adverse Effect Analysis Of Focused Ultrasound Ablation In The Treatment Of Benign Uterine Diseases

Objective: To analyze the adverse effects of focused ultrasound ablation(FUA)in the treatment for benign uterine diseases,and to explore the influencing factors related to the severe adverse effects.Methods: From November 2010 to April 2019,7614 patients with benign uterine diseases were treated with FUA in a certain grade-three general hospital.Among them,4886 patients had uterine fibroids,2278 patients had adenomyosis,255 had cesarean scar pregnancy,132 patients had abdominal scar endometriosis,47 patients had placenta increta,and 16 patients had a cornual pregnancy.The adverse effects were evaluated based on the classification system for adverse effects of the Society of Interventional Radiology.Results:1.All the patients completed FUA treatment under conscious sedation.The main adverse effects during the procedure of FUA were: pain in the treated area in 5261 cases(69.10%),sacrococcygeal pain in 3816 cases(50.12%),burning on skin in 2777 cases(36.47%),radiation pain in 805 cases(10.57%),groin pain in 501 cases(6.58%),pain at lower margin of buttock in 251 cases(3.30%),and pain in other parts in 234 cases(3.07%).However,the pain score was lower than 4 ponits.2.After FUA treatment,3,320 adverse events were observed.According to the classification system of Society of Interventional Radiology,the events comprised 3,069(40.31%)of Class A,213(2.80%)of Class B,16(0.21%)of Class C,and 22(0.29%)of Class D.No complication over Class D was observed.3.We define the adverse effects above Class C as major adverse effects.The incidence of major adverse effects 1.51% in 2011,0.78% in 2012,0.40% in 2013,0.54% in2014,0.75% in 2015,0.40% in 2016,0.59% in 2017,and reduced to 0.09% in 2018.The incidence of major adverse effects showed a downward trend.4.No significant difference was observed in the incidence of major adverse effects after FUA treatment among patients with uterine fibroids,adenomyosis,and abdominal wall endometriosis(P>0.05).Conclusion:1.FUA has a low incidence of major adverse effects in the treatment of benign uterine diseases,which can be safely and effectively used in the treatment of benign uterine diseases.2.With the development of this technique and more experience on the part of doctors,the incidence of major adverse effects has decreased and will be further lowered;This technique has become further mature in the treatment of gynecological benign diseases.