title: A comparison of ultrasound-guided high intensity focused ultrasound for the treatment of uterine fibroids in patients with an anteverted uterus and a retroverted uterus.
abstract: The aim of this study was to compare the treatment outcomes of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for uterine fibroids in patients with an anteverted uterus versus a retroverted uterus.
  
  
  
  Based on the principles of statistics we enrolled 221patients with an anteverted uterus and 221 with a retroverted uterus. All patients had a solitary uterine fibroid and every fibroid was identified as hypointense on the T2 weighted images (T2WI) on magnetic resonance. The baseline characteristics of the patients, treatment results and adverse events were compared between the two groups.
  
  
  
  There were no significant differences in baseline characteristics between the two groups. The average non-perfused volume ratio of fibroids was 85.2 ± 18.7% in the group of patients with a retroverted uterus, while it was 87.7 ± 11.8% in patients with an anteverted uterus (P < 0.05). The fibroids in patients with a retroverted uterus were treated using lower sonication power and longer sonication time. During the procedure patients with a retroverted uterus had a higher incidence of sciatic/buttock pain and groin pain, while patients with an anteverted uterus complained of lower abdominal pain or a burning sensation on the skin. Immediately after USgHIFU, the rates of sciatic/buttock pain and skin burn were significantly higher in patients with a retroverted uterus.
  
  
  
  The results of this study indicated that uterine fibroids with hypointensity on T2WI in a retroverted uterus can be safely and effectively treated with USgHIFU. However, the fibroids in an anteverted uterus are easier to treat with USgHIFU.
authors.affiliation: a Marshall College , University of California , San Diego, La Jolla , California , USA ;
authors.forename: Wenyi
authors.initials: W
authors.lastname: Zhang
authors.affiliation: b Department of Obstetrics and Gynaecology , Daping Hospital of the Third Military Medical University , Chongqing , China ;|d Department of Obstetrics and Gynaecology , Suining Central Hospital , Sichuan , China.
authors.forename: Min
authors.initials: M
authors.lastname: He
authors.affiliation: c State Key Laboratory of Ultrasound Engineering in Medicine Co-founded by Chongqing and the Ministry of Science and Technology, Chongqing Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering , Chongqing Medical University , Chongqing , China ;|d Department of Obstetrics and Gynaecology , Suining Central Hospital , Sichuan , China.
authors.forename: Guohua
authors.initials: G
authors.lastname: Huang
authors.affiliation: d Department of Obstetrics and Gynaecology , Suining Central Hospital , Sichuan , China.
authors.forename: Jia
authors.initials: J
authors.lastname: He
mesh_terms: D000328:Adult; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D014102:Torsion Abnormality / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014591:Uterine Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D014599:Uterus / Q000002:abnormalities
keywords: Anteverted uterus; retroverted uterus; ultrasound-guided high intensity focused ultrasound (USgHIFU); uterine fibroids/leiomyomas