Efficacy of high-intensity focused ultrasound ablation for adenomyosis therapy and sexual life quality.

Objective: The aim of this study was to evaluate the efficacy, safety and sexual life quality outcomes of ultrasound-guided high-intensity focused ultrasound (HIFU) ablations for the treatment of patients with symptomatic adenomyosis and uterine volumes >200 cm(3).

Methods: In our prospective clinical trial 47 patients with uterine volumes >200 cm(3) and symptomatic adenomyosis were treated with single treatment sessions of ultrasound-guided HIFU ablations. Beside uterus and adenomyosis lesion size reductions, outcome measures were symptom severity score (SSS), visual analogue scale (VAS) of dysmenorrhea, female sexual function index (FSFI) scores and the incidence of complications.

Results: In all 47 patients, the adenomyosis lesions sizes were significantly reduced 12 months after the interventions (P<0.01). The SSS and dysmenorrhea VAS scores were significantly reduced 12 months after the interventions (P<0.01) and the FSFI scores gradually improved during 12 months after the HIFU ablations (P<0.001). No serious complication occurred.

Conclusion: Ultrasound-guided HIFU ablation is a safe and effective noninvasive alternative for the treatment of uterine volumes >200 cm(3) with symptomatic adenomyosis. Particularly maintaining the integrity of patients' uteri leads to significant FSFI score improvements, which were essentially reduced before the HIFU treatments.