{"paper_id":"bf585af3-17b0-40ae-b88e-563b5e41b2ba","body_text":"Evaluation of rectal endometriosis treatment with high-intensity focused ultrasound versus surgery: A clinical retrospective multicenter trial\nAbstract\nObjective\nWe conducted a comparative retrospective bicentric study of rectal endometriosis treatment with high-intensity focused ultrasound (HIFU) and surgery in terms of symptoms and treatment-related morbidity at 6 months.\nMethods\nAll patients with a single symptomatic rectal nodule who had failed hormonal treatment were included in the present study. Patients' symptomatology was assessed using questionnaires: gynecologic and digestive symptoms (visual analog scale [VAS]), health status (MOSSF-36), fecal incontinence (Wexner), constipation (Knowles Eccersley Scott Symptom [KESS] score) and overall sexual health (FSFI). We also assessed the morbidity according to the Clavien–Dindo classification.\nResults\nA total of 120 patients, 60 in each group, received HIFU or rectal surgery. The characteristics of rectal nodules were similar in both groups. In the HIFU and surgery groups, Clavien–Dindo grades 2 and 3 complication rates were 3.3% versus 21.7% (P = 0.002) and 0% versus 10% (P = 0.01), respectively. Hospitalization duration was also significantly shorter for the HIFU group (1 vs 3 days; P < 0.001). In the HIFU group, significant improvement was observed in acute pelvic pain/dysmenorrhea (P < 0.001), dyspareunia (P < 0.001), diarrhea (P < 0.001), tenesmus/spasms (P < 0.001), pain on defecation (P < 0.001), and urinary urgency (P < 0.026). In the surgical arm, significant improvement was observed in acute pelvic pain/dysmenorrhea (P < 0.017), diarrhea (P < 0.002), tenesmus/spasms (P < 0.001), and pain on defecation (P < 0.002). In both groups, an improvement in FSFI, KESS, and Wexner scores and health status was noted at 6 months.\nConclusion\nIn selected patients with only one rectal location, HIFU treatment enables a similar symptom-related and quality-of-life outcome with a significant reduction in the risk of postoperative complications.\nCONFLICT OF INTEREST STATEMENT\nProfessor Dubernard is a consultant for EDAP TMS company. However, the authors declare no conflict of interest for this study.\nDATA AVAILABILITY STATEMENT\nResearch data are not shared.","source_license":"CC0","license_restricted":false}