High-intensity focussed ultrasound and hysteroscopy endo-operative system cold device procedures for treating >4cm diameter FIGO Type 2 uterine myoma and ensuring successful pregnancy

Abstract

Purpose

Laparotomic or hysteroscopic myomectomy, and high-intensity focussed ultrasound (HIFU), can be used in the treatment of Type 2 myomas with a > 50% intramural component. Hysteroscopic electroresection may damage the remaining endometrium and complete ablation of myomas may not be realised via HIFU treatment. We report and examine the results of 1 case of HIFU treatment, accompanied with the hysteroscopy endo-operative system (HEOS) cold device procedure.

Materials and methods

These were used for treating a > 4cm diameter Type 2 uterine myoma and ensuring successful pregnancy. HIFU treatment of uterine myomas can achieve point-by-point ablation of lesions as far as possible without damaging the endometrium. The HEOS cold device procedure was implemented 3 months after HIFU treatment.

Results

The patient got pregnant naturally in the third month after receiving treatment, with no complications during her pregnancy. The patient gave birth to a healthy male via full-term cesarean section.

Conclusions

HIFU treatment, accompanied with the HEOS cold device procedure, ensured complete myoma removal. It also preserved the integrity of the myometrium and prevented uterine perforation during surgery.

SHORT CONDENSATION

For the patient who had a large uterine myoma and wanted to achieve pregnancy soon, HIFU accompanied with the HEOS cold device procedure could ensure complete myoma removal, whilst preserving the integrity of myometrium and preventing uterine perforation during surgery.

摘要

目的：经腹或宫腔镜下子宫肌瘤切除术和高强度聚焦超声（HIFU）可用于治疗壁内成分>50%的2型肌瘤, 宫腔镜电切术可能损伤子宫内膜, 通过HIFU治疗可能无法完全切除肌瘤。我们报道并调查了一例经HIFU和HEOS冷刀装置治疗的病例结局。

材料和方法：这些被应用于治疗直径>4cm的2型子宫肌瘤并确保了成功妊娠。HIFU治疗子宫肌瘤可在尽可能不损伤子宫内膜的情况下实现病灶逐点消融, HEOS冷刀在HIFU治疗后3个月实施。

结果：该患者于接受治疗后第3个月自然妊娠, 妊娠期间无并发症发生, 并足月剖宫产生下一健康男婴。

结论：HIFU联合HEOS冷刀手术治疗确保了肌瘤的完全切除, 还可以保留子宫肌层的完整性并防止术中子宫穿孔。

Keywords:

• Gynaecology
• myoma
• endometrium
• pregnancy

Ethical approval

This was a case report, not a case study. The patient information in this case report was anonymized. It was unnecessary to obtain the ethics committee’s approval for this case report due to the nature of the study.

Consent

The patient has given her informed consent in written form for publication of this article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study and do not concern the patient’s personal identifiable information are available from the corresponding authors [X. Wang and Y. Huang] upon reasonable request.