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High-intensity focused ultrasound feasible for uterine localized adenomyosis in small study

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – In a prospective trial to test the feasibility of laparoscopic high-intensity focused ultrasound (HIFU) ablation of uterine localized adenomyosis, Chinese researchers found the procedure to a safe and effective procedure.

Adenomyosis is often mistaken for leiomyoma, Dr. Zhu Yang and associates at Chongqing Medical University note in the June issue of Fertility and Sterility. However, successful long-term nonsurgical treatment of adenomyosis tends to be more difficult due to penetration of the ectopic endometrium into the myometrium.

In their study, seven women with uterine localized adenomyosis underwent the HIFU procedure, followed by planned hysterectomy, “considered worldwide to be the definitive treatment,” the authors note.

Coagulation necrosis without hemorrhage of the targeted adenomyosis was confirmed by macroscopic observation. Staining with a 2% 2,3,5-triphenyltetrazolium chloride solution indicated complete loss of cell viability of the treated tissue.

Irreversible cell death within the glandular epithelium and interstitial cells of endometrium and surrounding smooth muscle cells was confirmed by electron microscopy in all patients

The margin was very clear between the treated and untreated regions, Dr. Yang and colleagues note, with little temperature diffusion between the two.

“A long-term follow-up trial is needed to determine the future role of this novel therapy for the treatment of localized adenomyosis,” they conclude.

Fertil Steril 2009;91:2338-2343.