Abstract: Objective To evaluate the effect of ultrasound-guided focused ultrasound ablation (US-FUA) in the treatment of
intramural, submucosal and subserosal uterine fibroids. Methods We prospectively assessed the efficacy of US-FUA for
treatment of symptomatic uterine fibroids by determining the volume ablation ratio immediately after the treatment and
evaluating the volume changes of the uterine fibroids on contrast-enhanced MRI at 6 and 12 months after the treatment. The
symptom severity score (SSS) was examined before and at 6 and 12 months after the treatment. Results A total of 110 women
with 145 symptomatic fibroids undergoing US-FUA between August 2011 and December 2012 were enrolled. The fibroids
were located intramurally in 72 (49.7% ), submucosally in 49 (33.8% ) and subserosally in 24 (16.6% ) patients, who had
comparable mean volume ablation ratios [(93.2 ± 13.1)% vs (94.9 ± 9.3)% vs (89.6 ± 19.3)% , P>0.05]. The volume of the treated
fibroids was reduced by (47.3±20.8)%, (70.3±22.2)% and (47.8±13.6)% at 6 months after US-FUA and by (58.9±19.9)%, (82.0±
21.2)%, and (50.5±17.8)% at 12 months, respectively, demonstrating a more obvious volume reduction for submucosal fibroids
(P<0.05). The SSS scores of the 3 groups before treatment were 29.1±15.2, 34.8±14.5 and 26.6±23.4, respectively, which decreased
significantly to 18.4±15.8, 15.5±10.7, and 11.6±11.7 at 6 months (P<0.05) and to 18.9±13.2, 16.8±14.0, 11.5±9.1 at 12 months (P<
0.05). No major complications occurred in these patients during the 12-month follow-up. Conclusions US-FUA can yield high
ablation ratios for intramural, submucosal and subserosal fibroids and result in significant volume reduction and symptomatic
improvement at 6 and 12 months after the treatment, suggesting its value as a new noninvasive option for fibroid treatment in
patients who wish to preserve the uterus.