Feasibility of laparoscopic high-intensity focused ultrasound treatment for patients with uterine localized adenomyosis

Objective: To investigate the feasibility of laparoscopic high-intensity focused ultrasound (HIFU) ablation in the treatment of patients with uterine localized adenomyosis. Design: A prospective clinical trial. Setting: University teaching hospital. Patient(s): Seven patients with uterine localized adenomyosis. Intervention(s): Using a hand-held focused ultrasound transducer, the HIFU procedure was performed by the same gynecologist for the treatment of a targeted adenomyosis during the surgical procedure, followed by hysterectomy. Main Outcome Measure(s): Feasibility and effectiveness of HIFU treatment of localized adenomyomas. Result(s): Macroscopic and microscopic examinations showed that HIFU induced thermal ablation of a targeted adenomyosis in all patients. The treated adenomyosis presented typical characteristics of coagulation necrosis, and the margin between the treated and untreated regions was clear in 2,3,5-triphenyltetrazolium chloride staining. By using electronic microscopy and nicotinamide adenine dinucleotide-diaphorase stain, complete loss of cellular viability was identified in the treated tissue. Conclusion(s): The HIFU treatment is feasible and effective in the treatment of patients with uterine localized adenomyosis. It may provide a promising laparoscopic treatment for localized adenomyosis. (Fertil Steril (R) 2009;91:2338-43. (C) 2009 by American Society for Reproductive Medicine.)