High Intensity Focused Ultrasound Treatment For Women In Reproductive Age With Adenomyosis

Adenomyosis is characterized by the invasion of ectopic endometrialglands and stroma into the myometrium, which is more common in womenof reproductive age. The main clinical manifestations include menorrhagia,progressive dysmenorrhea, and even secondary infertility. The morbidity ofthis disease is8.8%to31.0%. Currently, gynecologists can offer patientswith traditonal operation,drug therapies and non-invasive treatments.Operations includes hysterectomy and lesion resection. Clinically,gynecologists’s medication includes GnRH-a, androgen, progesterone andmifepristone. Ultrasound-guided high intensity focused ultrasound(USgHIFU) or MR-guided (MRgHIFU) ablation are both non-invasivetreatments.The above clinical manifestations may cause many problems and affectthe quality of life of patients of reproductive age. It is necessary to find a new,safe and effective treatment for women with adenomyosis in child-bearingperiod. HIFU has been applied to treat adenomyosis, this study was toinvestigate the safety and efficacy of HIFU ablation for adenomyosis of reproductive age.Objectives: To retrospectively analyze the results of HIFU treatment forwomen of reproductive age with adenomyosis, evaluate the safety andefficacy of the treatment.Methods: A total of49patients (18ys≤age≤39ys) with adenomyosiswho underwent HIFU ablation between July2010and February2012at thefirst hospital affiliated to chongqing medical university were reviewed.Intraoperative and postoperative adverse effects were recorded; the severityof menorrhagia and dysmenorrhea was followed up at1,3,6,12and24months post treatment.Results:49reproductive-age patients completed HIFU treatmentsuccessfully, and no serious complications occured. Among the49cases,32had menorrhagia and45had dysmenorrhea before HIFU treatment. Rates ofpatients with increased menstrual flow before and had symptomaticremission1,3,6,12,24months after HIFU treatment were respectively63.3%,65.7%,67.9%,77.8%,80.0%, while rates of patients who haddysmenorrhea remission were91.1%,91.0%,93.0%,92.7%,75.0%.Conclusion: HIFU is a safe and efficient treatment forreproductive-aged women with adenomyosis.