MAGNETIC RESONANCE-GUIDED FOCUSED ULTRASOUND ABLATION IN THE MANAGEMENT OF SYMPTOMATIC ADENOMYOSIS: ASSESSMENT OF CLINICAL EFFICACY, SAFETY, AND IMPACT ON FERTILITY. A CASE SERIES
Introduction Adenomyosis is a common cause of chronic pelvic pain and impaired fertility in women. Traditional radical treatments, such as hysterectomy, are unacceptable for patients who wish to preserve reproductive function. The implementation of organ-sparing, non-invasive methods, such as Magnetic Resonance-guided Focused Ultrasound (MRgFUS), is highly relevant, especially given the limited experience in regional medical centers in Kazakhstan.
Materials and Methods A prospective case series study was conducted, including 69 patients with symptomatic adenomyosis treated with MRgFUS (ExAblate 2100 system) from 2022 to 2024. Inclusion criteria were strictly limited to ensure safety and technical applicability. Primary outcomes were assessed by the dynamics of pain syndrome by Visual Analogue Scale (VAS) and menstrual bleeding by Pictorial Blood Loss Assessment Chart (PBAC). Secondary outcomes included objective efficacy (Non-Perfused Volume, NPV via MRI at 3 and 6 months), safety, and pregnancy rate.
Results All 69 patients successfully tolerated the procedure. A significant clinical response was achieved in the majority: 85% reported reduced pain (VAS: 7.2 to 3.0), and 76% reported reduced menorrhagia. Objective efficacy was confirmed by NPV formation averaging 74% by 6 months. No late complications were registered. Three pregnancies were reported within 12 months post-procedure, two of which resulted in successful live births, indicating the preservation of reproductive function.
Conclusion MRgFUS is a highly effective, non-invasive, and safe organ-sparing treatment for symptomatic adenomyosis. The results align with international data, confirming its suitability, particularly for women interested in preserving fertility. This initial clinical experience in Kazakhstan demonstrates the need for further integration of MRgFUS into national clinical practice.
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Meirmanova M.М., Abiltayeva A.A., Abiltayev A.M., Myssaev A.О., Myssayeva G.M., Kairkhanov Ye.K., Kazangapov R.S., Siyazbekova Z.S. Magnetic Resonance-guided Focused Ultrasound Ablation in the Management of Symptomatic Adenomyosis: Assessment of Clinical Efficacy, Safety, and Impact on Fertility. A Case Series // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (6), pp. 77-83. doi 10.34689/SH.2025.27.6.009Похожие публикации:
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