Application Of High Intensity Focused Ultrasound Combined With Mirena In Treatment Of Chronic Pelvic Pain

Objective Chronic pelvic pain (CPP) treated with high intensity focused ultrasound(HIFU) combined with Mirena therapy，to observe the clinical efficacy and safety.And provide a sample，safe，effective new method for the treatment of chronicpelvic pain.Methods60patients diagnosed with gynecologic chronic pelvic pain，who werenot responsive to pharmacotherapy；the average（40.7±5.9）years， with average（3.5±1.4）years of history；They were randomly divided for the surgery and highintensity focused ultrasound combined with Mirena，30patients in each group；thescores of visual analogue scale (VAS) and plasma substance P levels beforetreatment，at7days，one month，and two months after treatment were noted down，the degrees of satisfaction at three and six months after treatment were evaluated andanalyzed retrospectively.Results1. The VAS，plasma substance P levels of two groups：The scores of VAS，plasma substance P levels of two groups before treatment（P>0.05）；at7days aftertreatment，the scores of VAS and plasma substance P levels of the surgery slightlyover the previous，may be related to the surgical trauma；at7days after treatment，the scores of VAS and plasma substance P levels of HIFU combined with Mirena thanthe former were significantly decreased（P<0.01）；The scores of VAS，plasmasubstance P levels at one month，at two months in the two groups were significantlylower than those before treatment after treatment （P<0.01）；Pain was relievedobviously or disappeared after treatment；at one month and two months aftertreatment，the scores of VAS，plasma substance P levels of surgery were lower thanHIFU combined with Mirena （P>0.05）. Description of the two groups improvepatient symptoms at the same time，patients with surgery in the near term pain reliefis slightly better than HIFU combined with Mirena.2. the degrees of satisfaction of two groups：At three months after treatment，the degrees of satisfaction of two groups were better； the surgery was higher thanHIFU combined with Miren（P>0.05）；at six months after treatment，the degrees of satisfaction in surgery group showed decreasing trends and compare to threemonths，there was significant difference（P<0.01）；The degrees of satisfication incombined treatment group maintained at a stable level in two months（P>0.05），andwhich were superior to those in surgery group （P<0.05）；Description HIFUcombined with Mirena in the stability of the efficacy and satisfaction are good.Conclusions1.The Pain of all patients was relieved obviously or disappeared afterHIFU combined with Mirena and surgery treatment； the scores of VAS，plasmasubstance P levels after treatment in two groups were significantly lower than thosebefore treatment.2. The degrees of satisfication in combined treatment group maintainedat a stable level and and which were superior to those in surgery group3. HIFU combined with LNG-IUS in treatment of CPP has goodcurative effect，is a safe and effective new method.