Experience with focused ultrasound ablation used in uterine leiomyoma

Objective: to study the clinical effectiveness and safety of focused ultrasound ablation (FUA) used in patients with uterine leiomyoma under guidance of magnetic resonance imaging (MRI) on the basis of clinicoinstrumental analysis. Setting: V. I, Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Russian Agency for Medical Technologies; Department of Obstetrics, Gynecology, and Perinatology, Faculty for Postgraduate Education of Physicians, I. M. Sechenov Moscow Medical Academy. Design: a prospective study. Subjects: 137 patients aged 27 to 56 years who had uterine leiomyoma. Forty-one patients were selected for FUA. Methods: general clinical, instrumental, and morphological studies. Results: FUA was performed in 33 patients successfully and in S patients unsuccessfully due to technological difficulties. Twenty-eight of the 33 patients were observed to have diminished menstrual bleedings, pains, and pressure on the adjacent organs, 2 patients had nagging pain during menstruation; menorrhagia persisted in 3. Small pelvic ultrasonography with color Doppler mapping indicated that 7-10 days after FUA for leiomyoma, the volume of the uterus and a dominant nodule reduced by on an average of 23 and 21%, respectively. The intensity of blood flow in the central parts of nodules decreased in 26 patients; nodular blood flow was undetectable in 7. Three months following FUA, the latter showed a clinical efficiency in all the patients; small pelvic magnetic resonance imaging demonstrated a considerable reduction in uterine volumes (by an average of 31%) and myomatous nodules (by an average of 40%). Conclusion: FUA is a rather promising noninvasive treatment for uterine leiomyoma.