Comparison of Reintervention Rates for Type 1 and Type 2 Uterine Fibroids Treated With HIFU Ablation With Varying Non‐Perfused Volume Ratios to That With TCRM
Objectives
The objective of this study is to investigate the correlation between long‐term reintervention rates following high‐intensity focused ultrasound (HIFU) ablation with varying non‐perfused volume ratios (NPVR) and hysteroscopic transcervical resection of myoma (TCRM) for type 1 and 2 fibroids. Additionally, the study aims to define the technical success criteria in this context.
Methods
This retrospective study included patients with type 1 and 2 fibroids who underwent treatment with HIFU or TCRM between January 2012 and December 2019. Follow‐up assessments were conducted to monitor reintervention rates. NPVR, assessed via magnetic resonance imaging (MRI) post‐HIFU treatment, served as a technical indicator for comparing reintervention outcomes between HIFU and TCRM. Logistic regression analysis was employed to identify factors influencing reintervention in patients.
Results
A total of 445 patients were enrolled, with successful follow‐up on 325 cases, including 181 cases in the HIFU group and 144 cases in the TCRM group, resulting in a follow‐up rate of 73%. When NPVR was ≥70% (n = 151), the long‐term reintervention rate following HIFU was comparable to that of TCRM. Binary logistic regression analysis revealed age and long‐term symptom relief as independent influencing factors influencing reintervention. The cut‐off value of age in patients from the HIFU group was determined as 41.5 using receiver operating characteristic curve (ROC) analysis. The reintervention rate was found to be 10.1% (n = 79) for patients aged over 41.5 years, compared to 34.7% (n = 72) for those aged below it.
Conclusion
HIFU emerges as an effective and reliable treatment modality for large type 1 and type 2 uterine fibroids, providing a viable non‐invasive alternative for their management. NPVR ≥70% can serve as a technical criterion for successful operation.