Effect of focused ultrasound ablation and myomectomy on pelvic adhesions in patients with uterine fibroids.

ABSTRACT

OBJECTIVE: To investigate the effects of focused ultrasound ablation (FUSA) versus conventional myomectomy on pelvic adhesions and fertility in the treatment of uterine fibroids. METHODS: The clinical data of 114 patients with uterine fibroids admitted to Northwest Women's and Children's Hospital from February 2020 to January 2023 were retrospectively analyzed, among which 61 cases were treated with FUSA and 53 cases received myomectomy. The length of surgery, bleeding, hospitalization days, incidence of pelvic adhesions, and ovarian reserve function indexes (FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone) and E2 (Estradiol)) were compared between the two groups. RESULTS: Compared to the myomectomy group, the FUSA group had shorter operation time (P<0.001), no bleeding (P<0.001), less hospitalization (P<0.001), lower incidence of pelvic adhesion (P = 0.020), and less impairment of ovarian reserve function (Increased FSH, LH and E2, all P<0.001). Logistic regression analysis showed that the maximum diameter of leiomyoma ≥5 cm (P = 0.008), the number of pregnancies ≥3 (P = 0.003) and intraoperative hemorrhage (P = 0.004) were independent risk factors for pelvic adhesion. CONCLUSIONS: FUSA is a safe and effective non-invasive method for the treatment of uterine fibroids that reduces postoperative complications and protects fertility potential, especially for female patients with fertility concerns. Future studies need to overcome existing limitations to improve reliability of evidence.