Abstract:

Aim: was to evaluate the effeciency of adenomyosis treatment with magnetic resonance-guided focused ultrasound (MRgFUS) ablation.

Materials and methods: from March 2012 to November 2014 on the base of «Federal Center of Medicine and Rehabilitation» of Russian Ministry of Health we have examined and treated by MRgFUS ablation 50 patients with adenomyosis. Criteria for patient selection for treatment by MRgFUS ablation were: age 25-49 years, adenomyosis symptoms, confirmed diagnosis of the disease on MRI, ultrasound and gynecological examination, technical ability to perform FUS ablation. Dynamical observation after treatment included: vaginal examination, pelvic MRI with contrast performed at 3rd, 6th and 12th month after MRgFUS ablation. Also, within a specified time patients were asked to fill a questionnaire to assess the severity of adenomyosis symptoms anc quality of life (SF-36).

Results: against the background of the treatment, patients noted significant symptoms reduction. The best result was noted 3 months after treatment: 47% of women had less abundant menstruation; 26% of patients noted a decrease of pain during menstruation; 30% of patients had decreased duration of menstruation. Positive trend maintained during a year.

Control pelvic MRI after 3 months showed positive trend for majority of patients (85%): uterus size decrease (average by 30%). From 6th to 12th month of observation, it was noted that the uterus size in 73% patients increased in comparison' to the first control study (3 months after the procedure), uterus thus again starts accumulating a contrast agent in the ablation area, indicating the restoration of blood flow.

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