4.5 Article

COMPARISON OF FOCUSED ULTRASOUND SURGERY AND HYSTEROSCOPIC RESECTION FOR TREATMENT OF SUBMUCOSAL UTERINE FIBROIDS (FIGO TYPE 2)

Journal

ULTRASOUND IN MEDICINE AND BIOLOGY
Volume 46, Issue 7, Pages 1677-1685

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.ultrasmedbio.2020.02.018

Keywords

Focused ultrasound surgery; High-intensity focused ultrasound; Effectiveness; Hysteroscopic myomectomy; Submucosal fibroids; Uterine fibroids

Funding

  1. National Key Technology RD Program [2011 BAI14 B01]
  2. National Instrumentation Program [2013 YQ030629]
  3. National Basic Research Program of China [2011 CB707900]

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The aim of the study described here was to compare the effectiveness of focused ultrasound surgery (FUS), which uses high-intensity focused ultrasound to perform tissue ablation, with that of hysteroscopic transcervical resection of myoma (TCRM) for the treatment of type 2 submucosal fibroids. A prospective cohort study was performed in patients who underwent FUS or TCRM from January 2012 to December 2014. Uterine Fibroid Symptom (UFS) and Quality of Life (QoL) questionnaires were used to measure fibroid-related symptoms and quality of life before and at 3, 6 and 12 mo after treatment. Technical results, adverse events and post-operative recovery times of both groups were also compared. A total of 81 patients with at least one type 2 submucosal fibroid were enrolled. The mean diameter of type 2 submucosal fibroids was 3.8 +/- 0.9 cm (range: 2.0-5.0 cm) for 39 patients in the FUS group and 3.5 +/- 0.8 cm (range: 2.0-4.8 cm) for the 42 patients enrolled in the TCRM group. No major complication occurred in any patients for either treatment. In both groups, the UFS score decreased significantly and the QoL score increased significantly from baseline successively at 3, 6 and 12 mo post-treatment (p < 0.05). Time spent in hospital post-treatment was significantly shorter (2.56 +/- 0.98 d) for the FUS group compared with the TCRM group (3.31 +/- 0.60 d) (p < 0.05). Time to return to work after treatment was also significantly shorter for the FUS group (3.14 +/- 0.83 d) than for the TCRM group (6.09 +/- 0.9 d) (p < 0.05). FUS and TCRM are both tolerable and effective treatments with significant improvement of symptom and quality of life for patients with type 2 submucosal fibroids <= 5 cm in diameter. (E-mail: chenjy@cqmu.edu.cn) (c) 2020 World Federation for Ultrasound in Medicine & Biology. All rights reserved.

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