High-Intensity Focused Ultrasound Surgery of Uterine Myomas

Uterine fibroids (UFs) are the most common benign neoplasms of the uterus, observed in more than 50% of women. Such tumors can be asymptomatic or can cause symptoms requiring treatment. Current treatment methods include medical therapy, myomectomy, hysterectomy, uterine artery embolization (UAE), percutaneous ablation and focused ultrasound surgery (FUS). FUS is a relatively recent technique that uses the thermal and mechanical effects of ultrasounds, inducing the ablation of a target tissue without damaging the surrounding structures. FUS can be conducted under an imaging guidance, which can be either ultrasound (US-guided FUS, USgFUS) or magnetic resonance (MR-guided FUS, MRgFUS). Patient characteristics and UF morphological features have to be checked prior to treatment, in order to assess eligibility for the procedure. As a minimally invasive method, it can be performed in an outpatient setting, without requiring general anesthesia. FUS has been demonstrated to reduce UFs related symptoms, with low adverse event and reintervention rates. Pregnancy is possible after treatment, although there is still a lack of good-quality data on this topic.