P11.05: Clinical efficacy of MRgFUS in treatment of adenomyosis: 12 month follow‐up

The efficacy of MRgFUS in the treatment of uterine adenomyosis and the attendant adverse events were evaluated at 12 months postoperatively. Thirty-nine women (mean age 40.9 ± 5.0 years) with symptomatic adenomyosis who had completed their family planning, were treated with MRgFUS which is being commonly used in the treatment of uterine myoma. Uterine volume was calculated from MR images obtained before, and at 6 and 12 months after MRgFUS. The patients filled out questionnaires before and 1, 3, 6 and 12 months after MRgFUS for assessing their subjective evaluation of satisfaction and effectiveness for symptom improvement. The mean uterine volume was 89% (range 44%–129%) at 6 months and 90% (range 59%–140%) at 12 months postoperatively. The rate of satisfaction was 90, 95, 95 and 91% at 1, 3, 6 and 12 months respectively. Symptom improvement was 90, 90, 95 and 91% at 1, 3, 6 and 12 months, respectively. One patient conceived 6 months after MRgFUS, 2 patients underwent hysterectomy at 10 and 11 months and 2 patients received hormonal therapy at 9 and 11 months. By adding the 4 cases who underwent alternative treatment to negative-response questionnaires (since no questionnaires were obtained from them after the 6 months follow-up), the rates of satisfaction and symptom improvement were 82% and 82%, respectively, at 12 months. Twenty-two patients complained of watery discharge at 1 month after MRgFUS; the number decreased by 2 at 12 months, and 2 patients complained of lumbago until 6 months. Although treatment of adenomyosis with MRgFUS did not show marked shrinkage of uterine volume, symptom improvement and patient satisfaction were reported up to 12 months, suggesting that pathologic activity decreased by 12 months as a result of the ablation of adenomyosis tissue.