A retrospective study of ultrasound-guided high intensity focussed ultrasound ablation for multiple uterine fibroids in South Africa

摘要

Objective: To evaluate the shrinkage rate, symptom relief and improvement of the quality of life following ultrasound-guided high intensity focussed ultrasound (USgHIFU) for multiple uterine fibroids.Methods: From October 2015 to November 2016, 81 black women with multiple symptomatic fibroids underwent USgHIFU. The number of the fibroids ranged from 3 to 9. The shrinkage rate of fibroids, symptom severity score and quality of life were evaluated following USgHIFU. Magnetic resonance imaging (MRI), the uterine fibroid symptom and quality of life (UFS-QOL) questionnaire were used for evaluation.Results: The mean age of patients was 35.35.9years. The average weight of these patients was 68.4 +/- 11.4kg, with the median abdominal subcutaneous fat thickness of 38.0 +/- 11.4mm. The median fibroid volume was 36.0 (range: 1.8-1220.1)cm(3). During HIFU, 60.5% of the patients reported lower abdominal pain, 43.2% sciatic/buttock pain, 60.5% skin burning sensation, 6.2% abnormal vaginal discharge and 13.6% transient leg pain. No severe complications were observed. The average volume reduction rate of fibroids in 21 patients who completed the follow-up was 32.5 +/- 24.0, 42.3 +/- 32.2 and 52.5 +/- 36.3% 1, 3 and 6months after HIFU, respectively. The UFS score decreased and the QOL values significantly increased during the follow-up period. Re-intervention treatment occurred in two of the 21 patients 6months after HIFU. One patient conceived 3months after HIFU, and she had a term vaginal delivery without any obstetrical complications.Conclusions: Based on our results, USgHIFU is safe and effective in treating patients with multiple uterine fibroids.