Our Summary

This study aimed to test the effectiveness and safety of a treatment method called high-intensity focused ultrasound (HIFU) on patients with a specific type of uterine tumors called fumarate hydratase (FH)-deficient uterine leiomyomas. This was done at the Third Xiangya Hospital from July 2017 to January 2023, with 10 patients participating.

The patients had a median age of 32 years, and most of them had multiple uterine tumors. The largest tumor was about 56 mm in diameter on average. Through imaging, it was determined that the tumors of most patients appeared as mixed intensity.

The treatment was successfully completed in one session for all patients, and no major side effects were reported. The treatment managed to reduce the blood supply to the tumors (a measure called nonperfusion volume ratio or NPVR) by about 40% on average. Some patients experienced a greater reduction of up to 70%.

Three months after the treatment, more than half of the patients who had symptoms before the treatment reported improvement. Six months after the treatment, half of these patients were still feeling better. However, all patients needed further treatment by March 2024. The need for additional treatment increased over time, with 20% needing it after 12 months, 70% after 24 months, and 90% after 36 months.

In conclusion, HIFU is a safe and feasible treatment method for this type of uterine tumors, providing effective results in the short term. However, most patients needed further treatment over time, indicating that the long-term effects of this treatment are limited.

FAQs

  1. What is high-intensity focused ultrasound (HIFU) and how was it used in this study on uterine tumors?
  2. What were the short-term and long-term results of using HIFU on patients with FH-deficient uterine leiomyomas?
  3. Did the patients experience any major side effects from the HIFU treatment?

Doctor’s Tip

A helpful tip that a doctor might give a patient about uterine ablation is to discuss with them the potential need for further treatment in the future. It’s important for patients to understand that while uterine ablation may provide short-term relief, some patients may require additional treatment down the line. It’s crucial for patients to stay in close communication with their healthcare provider and to follow up regularly to monitor their condition and determine if further treatment is needed.

Suitable For

Uterine ablation is typically recommended for patients with heavy menstrual bleeding that does not respond to other treatments such as medication or hormonal therapy. It may also be recommended for patients with uterine fibroids or polyps that are causing symptoms such as pelvic pain or pressure.

In the case of FH-deficient uterine leiomyomas, as mentioned in the study above, patients with this specific type of uterine tumors may be recommended for uterine ablation using HIFU. This treatment method can effectively reduce blood supply to the tumors and improve symptoms in the short term. However, as seen in the study, additional treatment may be needed over time due to the potential for tumor regrowth or the development of new tumors.

Timeline

Overall, the timeline of a patient’s experience before and after uterine ablation can be summarized as follows:

Before uterine ablation:

  • Patient presents with symptoms such as heavy menstrual bleeding, pelvic pain, and other issues related to uterine fibroids or tumors.
  • Diagnostic tests, such as imaging studies, are performed to confirm the presence and characteristics of the tumors.
  • Treatment options are discussed with the patient, and a decision is made to proceed with uterine ablation.

During and immediately after uterine ablation:

  • Uterine ablation procedure is performed, either through techniques such as high-intensity focused ultrasound (HIFU) or other methods.
  • The procedure is completed successfully in one session, with no major side effects reported.
  • Blood supply to the tumors is reduced, leading to a decrease in tumor size and symptoms in some patients.

After uterine ablation:

  • Patients experience improvement in symptoms in the short term, with more than half reporting relief at the three-month mark.
  • However, over time, the need for further treatment increases, with most patients requiring additional interventions within three years.
  • Long-term effectiveness of uterine ablation may be limited, as indicated by the increasing need for further treatment over time.

In summary, uterine ablation can provide effective short-term relief for patients with uterine fibroids or tumors, but long-term outcomes may vary, and many patients may require additional treatment in the future. It is important for patients to discuss the potential benefits and limitations of uterine ablation with their healthcare providers before deciding on this treatment option.

What to Ask Your Doctor

Some questions a patient should ask their doctor about uterine ablation include:

  1. What are the benefits and risks of uterine ablation compared to other treatment options for my specific condition?
  2. How many sessions of uterine ablation will I need, and how long will each session take?
  3. What should I expect during and after the procedure in terms of pain, recovery time, and potential side effects?
  4. Will uterine ablation affect my fertility or future pregnancy plans?
  5. How long will the effects of uterine ablation last, and will I need additional treatments in the future?
  6. Are there any lifestyle changes or restrictions I need to follow after undergoing uterine ablation?
  7. What is the success rate of uterine ablation for patients with similar conditions to mine?
  8. How often will I need follow-up appointments to monitor my condition after the procedure?
  9. Are there any specific warning signs or symptoms I should watch out for after uterine ablation?
  10. Can you provide me with more information or resources about uterine ablation to help me make an informed decision about my treatment options?

Reference

Authors: Zhang L, Liao Z, Jiang J. Journal: Int J Hyperthermia. 2024;41(1):2384459. doi: 10.1080/02656736.2024.2384459. Epub 2024 Jul 29. PMID: 39074841