Assessment Of Clinical Symptoms And Quality Of Life Of Patients With Adenomyosis In Ultrasound Guided High Intensity Focused Ultrasound Ablation

Background Patients with adenomyosis often complain constantlyaggravating dysmenorrhea, which seriously affect the quality of patients’life. Invasive surgery, such as hysterectomy and the local excision ofadenomyotic lesions, do great harm to patients in physiological andpsychological. The related symptoms are easily recurrent after thediscontinuation of drug administration in the conservative therapies. Thus,high intensity focused ultrasound(HIFU) ablation as minimally invasiveand noninvasive technique can be a new treatment choice for women withadenomyosis. A few studies have suggested that HIFU ablation is afeasible and safe technique for adenomyosis, and that most patientsexperience symptomatic relief. But relatively detailed evaluation ofdysmenorrhea relief and the correlation between dysmenorrhea relief andthe quality of life (QOL) improving are not be investigated. So they arewhat we do to further prove the effectiveness of HIFU ablation foradenomyosis.Objective To evaluate the effectiveness of HIFU ablation treatmenton adenomyosis through assessing the relief of clinical symptoms andquality of life.Methods38patients of adenomyosis underwent ultrasound-guidedHIFU ablation (USgHIFU). Follow up3months, all adverse effects were recorded,the quality of life was evaluated via Uterine Fibroids Symptomand Quality of Life (UFS-QOL) questionnaire and the dysmenorrhea wasevaluated via Short Form of McGill Pain Questionnaire（SF-MPQ）whichincluding Pain Rating Index（PRI）score, Visual Analogue Scale (VAS)score, Present Pain Intensity （PPI） score. All patients underwentpre-treatment and post-treatment pelvic enhanced MRI.Results38patients completed the USgHIFU ablation treatment in1session. A non-perfused volume ratio of64.1±16.1%was achieved. Noserious adverse effects were observed. Compared with baseline data, theUFS sore,PRI score, VAS score and PPI score all decreased significantlyafter USgHIFU ablation treatment at the3month(P＜0.05),and the QOLscore increased significantly（P＜0.05）. There existed correlation betweenthe variation of dysmenorrhea and the variation of QOL. Differentnon-perfused volume ratio had significantly different clinical effect.Conclusions USgHIFU was found to be an effective and safetechnique for adenomyotic lesions to alleviate the symptom ofdysmenorrhea and improve the quality of patients’ life. What’ more, therelief of dysmenorrhea and the improvement of QOL had correlation. Thelarger of non-perfused volume ratio,the more relief of dysmenorrhea andthe better quality of patients’ life.