Comparative Study Of High Intensity Focused Ultrasound Treatment For Intramural Uterine Fibroids And Subserosal Uterine Fibroids

Objective：To study the efficacy and safety of high intensity focused ultrasound(HIFU) treatment for intramural uterine fibroids (IUF) and subserosaluterine fibroids (SUF).Methods：261cases of uterine fibroids who had received HIFU treatment in HIFUcenter of Suining Central Hospital from January2013to December2013were selected, in which158patients with IUF were recruited as IUF groupand103patients with SUF were recruited as IUF group. To investigate theefficacy and safety of HIFU treatment for those two types of uterine fibroids,the clinical symptoms such as menorrhagia, dysmenorrhea, frequenturination, constipation and anemia were compared between two groups.Furthermore, HIFU treatment parameters such as the fibroids volume,average sound intensity，exposure time，total energy，the NPV ratio (whichwas defined as non-perfused volume divided by the fibroid volume immediately after HIFU treatment) were also compared; The side effectsduring HIFU treatment and in3days after HIFU treatment; the reduction ofuterine fibroids volume follow-up at3、6、12months by Doppler ultrasoundimaging；The improvement of symptoms follow-up at12months by Uterinefibroids Symptom severity Scale（UFS-8）were observed and analysed.Result:1. The average age and clinical symptoms such as menorrhagia,dysmenorrhea, frequent urination, constipation and anemia do not havesignificantly statistical difference in patients with IUF and patients with SUF(P>0.05).2. All patients received HIFU treatment successfully. The meanvolume、average sound intensity and the mean NPV ratio do not havesignificantly statistical difference in two types of uterine fibroids (P>0.05);The exposure time and total energy of IUF were significantly statisticalhigher than that of SUF (P<0.01).3. The side effects during and in3days after HIFU treatment: noserious complications occurred in any patients.①side effects during HIFU treatment: Only sciatic pain and treatmentarea pain were statistically different between the two groups of patients(P<0.05). Patients with IUF had other side effects including one with pubicsymphysis pain, one with anal bulge，one with heart rate and blood pressurereduction; One patient with SUF had symphysis sting as other side effects. ②Side effects in3days after HIFU treatment: Fever, lower abdominalpain, sciatic pain, lower extremity sensorimotor dysfunction, vaginaldischarge, skin injury and Other side effects were compared， there were nosignificantly statistical difference between the two groups of patients(P>0.05). Patients with IUF had other side effects including one withhematuria and one with two sides of groin pain; One patients with SUF hadurine sting as other side effects.4. The reduction of uterine fibroids volume during follow-up: Threefailed treatment was found in IUF. Follow-up Doppler ultrasound imaging at3months、6months、12months, there were no statistical differencesbetween the two types of uterine fibroids in the reduction of fibroids volume(P>0.05). Follow-up at12months by UFS-8: The score reduction of twogroups of patients were not statistically different (P>0.05).Conclusion：1. High intensity focused ultrasound treatment for intramural uterinefibroids and subserosal uterine fibroids are both safe and effective, highintensity focused ultrasound (HIFU) treatment is an optional choice forpatients with SUF and patients with IUF.2. The intramural uterine fibroids required greater total energy andlonger exposure time than the subserosal uterine fibroids, but high intensityfocused ultrasound treatment for intramural uterine fibroids and subserosaluterine fibroids are both effective.