P29.05: Two‐year outcome of MRgFUS treatment of adenomyosis

To evaluate the efficacy of MRgFUS treatment of adenomyosis over a 2-year follow-up, symptom severity, alternative treatment and adverse events were examined. Thirty-nine women (mean age 40.9 years), with symptomatic adenomyosis who had completed their family planning, were treated with MRgFUS commonly used in the treatment of uterine myoma. During the first year of follow-up, the patients visited our clinic at 1, 3, 6 and 12 months and were given an 8-item questionnaire to determine symptom severity score (SSS). Thereafter, the same questionnaire was mailed to the patients every 6 months. A high SSS indicated severe symptoms. Follow-up was discontinued when patients underwent hormonal treatment, hysterectomy because of treatment failure or became pregnant possibly as a consequence of a change in symptoms. Two patients were lost to follow up at the end of the second year. Within one year of MRgFUS, 2 patients underwent hormonal treatment, 2 underwent hysterectomy and 1 became pregnant (who later underwent a legal abortion). In the subsequent one year, 7 patients underwent hormonal treatment, 1 underwent hysterectomy and 1 became pregnant (who later aborted spontaneously). At the 2-year follow-up, 23 patients needed no major treatment other than pain relievers or anti-anemic agents. The mean SSS of 51.2 before treatment decreased significantly to 35.9 at 1 month and to 26.9 at 3 months after MRgFUS and subsequently to 30.9, 30.3, 24.0 and 24.0 at 6, 12, 18 and 24 months, respectively. Two patients still complained of watery discharge. Twelve of the 39 patients underwent hormonal or surgical treatment by the end of 2 years after MRgFUS; however, the remaining 23 patients received no active treatment for adenomyosis. Two patients became pregnant although they had completed family planning, suggesting the possibility of pregnancy after MRgFUS.