Clinical Analysis Of High Intensity Focused Ultrasound Ablation For Adenomyosis Coexisting With Uterine Leiomyoma

Adenomyosis and uterine leiomyoma both are common non-malignant diseases of reproductive age women, which existing alone or coexisting with each other can cause symptoms like menorrhagia, dysmenorrhea and pelvic pressure. Adenomyosis coexisting with leiomyomas are common. The patients concomitant adenomyosis with leiomyomas compared to patients with leiomyomas alone have higher symptom scores, and mean age at hysterectomy seems earlier than women with leiomyomas or adenomyosis alone. The only way to radical treatment is hysterectomy. Endocrine therapy has some limitations, such as side effects, short-term use and unsatisfied efficacy. HIFU has been widely applied in treatment of adenomyosis or uterine fibroid, advantages of which,such as non-invasive, recovering soon and repeatable are welcomed by physicians and patients. HIFU ablation for adenomyosis concomitant with leiomyomas has not been reported yet, and the safety and efficacy need futher exploration. ObjectivesEvaluate safety and short-term efficacy of HIFU ablation for uterine adenomyosis coexisting with uterine leiomyomas. Methods45 patients with adenomyosis coexisting with uterine leiomyomas treated with HIFU at Chongqing Haifu Hospital between 2011,April to 2015,June were analyzed. Enhanced MRI were performed 1day after HIFU ablation and the clinical symptoms were recorded at 1, 3,6 months after the treatment. The adverse effects or complications were also recorded in the process of treatment and after treatment. ResultsAll patients accomplished the treatments with minor adverse effects,and no severe complications were observed after the treatment. 21 of 45(46.67%), 20 of 45(44.44%) and 4 of 45(8.89%) patients with adenomyosis and leiomyoma lesions were remarkably, partially and no obviously ablated, respectively. Dysmenorrhea scores at 1,3,6 months after the treatment are compared with dysmenorrhea scores before ablation via paired Student t test, respectively, and the results showed a significant statistical difference(P<0.01). Dysmenorrhea completely,partial and no remission rate at 1,3,6 months after the treatment are 85.37%, 80.49%, 85.37% and 7.32%, 12.20%, 7.32% and 7.32%、4.88%、7.32%,respectively. Meanwhile,menorrhagia completely remission,no change and symptom aggravated rate at 1,3,6 months after the treatment are 76.92%, 73.08%, 69.23% and 11.54%、15.38%、11.54% and 11.54%、11.54%、19.23%,respectively. ConclusionHIFU ablation seems to be a safe method, with minor side effects and good short-term efficacy to treat adenomyosis coexisting with leiomyomas.