Safety And Efficacy Of High Intensity Focused Ultrasound Treatment For Perimenopausal Women With Adenomyosis

Adenomyosis is a common benign gynecological disease in women ofreproductive age. It is characterized by the invasion of ectopic endometrialglands and stroma into the myometrium. The main clinical manifestationsinclude menorrhagia, prolonged menstrual period, progressivedysmenorrhea, and even cause infertility. Currently, gynecologists can offerpatients with hysterectomy or adenomyomectomy and drug therapies.Among which, hysterectomy is the only definitely treatment. However,hysterectomy may cause many problems and affect the quality of life ofpatients. For premenopausal women with adenomyosis, whose ovarianfunctions begin to decline, it is necessary to find a new, safe and effectivetreatment for perimenopausal women with adenomyosis.In recently years, high intensity focused ultrasound (HIFU) has beenapplied to treat adenomyosis. HIFU is capable of producing coagulativenecrosis at a precise focal point within the ectopic endometrial tissue,without harming the overlying and adjacent structures even within the pathof the beam. However, there isn’t enough evidence about the efficacy of HIFU ablation for perimenopausal patients with adenomyosis.The aim of the present study was to investigate the safety and efficacyof HIFU ablation for perimenopausal adenomyosis.ObjectivesTo retrospectively analyze the results of HIFU treatment forperimenopausal women with adenomyosis, evaluate the safety and efficacyof the treatment.MethodsA total of67perimenopausal patients (age≥46ys) with adenomyosiswho underwent HIFU ablation between January2011and April2013atSuining Central Hospital were reviewed. Intraoperative and postoperativeadverse effects were recorded; the severity of menorrhagia anddysmenorrhea was followed up at1,3,6and12months post treatment.ResultsAmong67perimenopausal patients with adenomyosis treated by HIFU,54had menorrhagia and61had dysmenorrhea before HIFU treatment. Allpatients completed HIFU treatment successfully. The major discomforts thatpatients complained during the procedure included pain in the treatment area,pain in sacrococcygeal region and “hot sensation” of skin, which usuallydisappeared within24hours; a few patients need analgesics. Based on the SIR classification, most of the adverse effects were classified as A to B, noC to F was found. Follow-up results showed that the menorrhagia anddysmenorrhea scores, the volume of the uterus and adenomyosis weredecreased significantly at1,3,6and12months after HIFU (p<0.05).ConclusionHIFU is a safe and efficient treatment option for perimenopausalwomen with adenomyosis. It can be a bridge to perimenopausal patients toavoid having hysterectomy. Thus, it is a promising treatment option forpremenopausal patients with adenomyosis.