Adverse effect analysis of high-intensity focused ultrasound in the treatment of benign uterine diseases

Abstract

Based on the results with low rate of major adverse effects from multiple centers, we concluded that HIFU is safe in treating patients with benign uterine diseases. With development of this technique and more experience on the part of the physicians, the rates of the major adverse effects will be further lowered.

Adverse events of focused ultrasound surgery for uterine fibroids and adenomyosis

“…This adverse effect was caused due to a necrotic tumor, local inflammation, and ulceration of the nonperfused tissue ( Figure 7), which often disappeared without any medications. 6,9,10,13,14…”

“…6,9,10,13 Nevertheless, heavy vaginal discharge should be considered as an adverse event, which can conceivably result in anemia. 14 Kim et al showed that a 41-year-old patient with a 5.5 cm submucosal leiomyoma underwent MRI-guided FUS therapy and reported heavy vaginal discharge, implying that she did not adapt to medications at 8-month post-treatment. Her blood test further exhibited a hemoglobin concentration of 5.0 mIU/L, for which a blood transfusion was performed to increase the hemoglobin concentration up to 9.2 mIU/L, while the MRI showed a 6.1 cm submucosal leiomyoma, for which a surgery was performed to eradicate the tumor.…”

“…Furthermore, all 38 patients with severe skin burns also had prior abdominal scars owing to older surgeries, and the burned tissues were eliminated through surgical excision. 14 It was concluded that strict observation during the process of FUS ablation was essential to prevent not only excessive heat accumulation in the near-field, such as fat edema, but also skin burns. [9][10][11][12][13][14] Clinicians should consider using the angulation of the transducer, beam shaping ( Figure 3), scar patches ( Figure 4), or miscellaneous methods ( Figure 5) to reduce the risk of skin or scar burn.…”

“…14 It was concluded that strict observation during the process of FUS ablation was essential to prevent not only excessive heat accumulation in the near-field, such as fat edema, but also skin burns. [9][10][11][12][13][14] Clinicians should consider using the angulation of the transducer, beam shaping ( Figure 3), scar patches ( Figure 4), or miscellaneous methods ( Figure 5) to reduce the risk of skin or scar burn. 12,15,16 Bone tissues facilitate the absorption of sonication energy, augmenting heat accumulation in bones and injuring the skin, the subcutaneous fat layer surrounding this area, and even the bone.…”

“…Duc et al common symptoms of back, buttock, leg, sacrococcygeal pain, and numbness. 9,10,[13][14][15]17 In Hwang et al's study, after the adoption of ultrasoundguided FUS therapy, patients reported severe back pain and computed tomography (CT) results revealed air inside the T5 to S1 vertebrae and bone destruction at the L5 vertebra. Moreover, a biopsy under CT guidance was performed, and the histopathological osteolytic samples showed acute inflammatory cell infiltration in the bone marrow and necrotic bone particles.…”