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

Fertil Steril. 2009 Jun;91(6):2338-43. doi: 10.1016/j.fertnstert.2008.03.017. Epub 2008 Apr 28.


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.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cell Death
  • Endometriosis / pathology*
  • Endometriosis / therapy*
  • Female
  • Humans
  • Necrosis
  • Prospective Studies
  • Ultrasonic Therapy / methods*
  • Uterine Diseases / pathology*
  • Uterine Diseases / therapy*
  • Uterus / pathology
  • Uterus / ultrastructure