At our centre, up to April 2013, 319 patients were treated with a total of 399 HIFU procedures, with a mean non-perfused volume after treatment of 52%.
Most patients had menometrorrhagia (82%) while 18% had compression syndrome.
According to the Funaki classification, 42% of the fibroids we have treated were type I, 45% type II and 15% type III.
Our experience has been that at 3 months, patients already experience a significant reduction in symptoms of over 20 points, which is maintained beyond 2 years, with the increase in quality-of-life score being significant from one year on (Table 1).
The figures show a 38% decrease in volume at 3 months, 40% at 6 months, 50% at 1 year, 56% at 2 years and 65% at 3 years.
The failure rate (need for surgery or other treatments) ranges between 5% and 20% depending on the type of fibroid.In analysing the cases of treatment failure in terms of degree of vascularisation, 70% were found to be very vascularised, 22% moderately vascularised and only 8% had very little vascularisation.
In published studies, the results obtained with the HIFU JC system are consistent with those obtained in our series.
The complications observed are mild, except for one case of a small 3rd degree burn and for reasons not directly related to the treatment. The rest are skin erythema in 21 patients, 10 cases of self-limiting haematuria, 5 cases of spotting and 1 case of self-limiting fever lasting less than 24 hours.
In conclusion, we can say that ultrasound therapy is safe and effective in most fibroids.
The failure rate (need for other treatments) is below 5% in sparsely vascularised and type I fibroids. It does, however, need to be borne in mind that in the highly vascularised or type III fibroids, the failure rate is much higher. In these cases, the indication for treatment has to be carefully assessed; it could be applicable in selected cases in combination with hormone treatment. Type III fibroids that are also highly vascular should not be treated with this technique.