Pretreatment bowel manipulation during ultrasound-guided high-intensity focused ultrasound therapy for posterior wall uterine masses

Objective: High-intensity focused ultrasound (HIFU) therapy is a noninvasive alternative to conventional abdominal surgery in obstetrics and gynecology. The aim of this study is to evaluate the reduction of pain intensity with bowel manipulation before ultrasound-guided HIFU treatment in women with...

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Autores principales:	Meng-Hsing Wu, Yu Zhang, Dexin Chen, Ningbo Zhou, Hui Li, Lingling Peng, Min-Syuan Huang, Tsung-Cheng Kuo
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Myoma Adenomyosis Anal catheterization Pain intensity Visual analog scale Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/fe2094f0cd524edcb7bf03eb9cc70a95
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spelling	oai:doaj.org-article:fe2094f0cd524edcb7bf03eb9cc70a952021-11-18T04:44:46ZPretreatment bowel manipulation during ultrasound-guided high-intensity focused ultrasound therapy for posterior wall uterine masses1028-455910.1016/j.tjog.2021.09.020https://doaj.org/article/fe2094f0cd524edcb7bf03eb9cc70a952021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1028455921002606https://doaj.org/toc/1028-4559Objective: High-intensity focused ultrasound (HIFU) therapy is a noninvasive alternative to conventional abdominal surgery in obstetrics and gynecology. The aim of this study is to evaluate the reduction of pain intensity with bowel manipulation before ultrasound-guided HIFU treatment in women with posterior wall uterine fibroids and/or adenomyosis. Materials and methods: This is a multicenter retrospective observational study. Data from all patients who underwent HIFU therapy at three HIFU clinics (Sichuan Maternal and Child Health Hospital, Xiangya Hospital of Central South University, and Kuo General Hospital) between January 2019 and December 2019 were analyzed. We compared pain intensity with and without bowel manipulation during the HIFU treatment and evaluated tolerability without intravenous sedation. The presence of discomfort or pain during the HIFU procedure was evaluated using the visual analog scale (VAS). Results: A total of 86 women were included in this study. All women underwent HIFU therapy with the PRO-2008 system in the supine position for posterior wall uterine fibroids and/or adenomyosis. Thirty-seven women received pretreatment anal catheterization with a condom and 49 women were not subjected to bowel manipulation. All patients received pretreatment condom-catheter device were well tolerated during the procedure of bowel manipulation. During the HIFU procedure, the women who had received bowel manipulation experienced lower pain intensity, especially less sacrococcygeal pain (VAS score 1.56 ± 1.46 vs 2.89 ± 1.61), target region pain (1.54 ± 1.30 vs 2.53 ± 1.29), and radiating pain (0.13 ± 0.34 vs 0.41 ± 0.54), compared with the women without bowel manipulation. Conclusion: Bowel manipulation with anal catheterization before HIFU therapy for posterior wall uterine masses can be safely performed and is effective as a low risk intervention to aid in reducing potential HIFU complications related to nerve involvement.Meng-Hsing WuYu ZhangDexin ChenNingbo ZhouHui LiLingling PengMin-Syuan HuangTsung-Cheng KuoElsevierarticleMyomaAdenomyosisAnal catheterizationPain intensityVisual analog scaleGynecology and obstetricsRG1-991ENTaiwanese Journal of Obstetrics & Gynecology, Vol 60, Iss 6, Pp 1078-1083 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Myoma Adenomyosis Anal catheterization Pain intensity Visual analog scale Gynecology and obstetrics RG1-991
spellingShingle	Myoma Adenomyosis Anal catheterization Pain intensity Visual analog scale Gynecology and obstetrics RG1-991 Meng-Hsing Wu Yu Zhang Dexin Chen Ningbo Zhou Hui Li Lingling Peng Min-Syuan Huang Tsung-Cheng Kuo Pretreatment bowel manipulation during ultrasound-guided high-intensity focused ultrasound therapy for posterior wall uterine masses
description	Objective: High-intensity focused ultrasound (HIFU) therapy is a noninvasive alternative to conventional abdominal surgery in obstetrics and gynecology. The aim of this study is to evaluate the reduction of pain intensity with bowel manipulation before ultrasound-guided HIFU treatment in women with posterior wall uterine fibroids and/or adenomyosis. Materials and methods: This is a multicenter retrospective observational study. Data from all patients who underwent HIFU therapy at three HIFU clinics (Sichuan Maternal and Child Health Hospital, Xiangya Hospital of Central South University, and Kuo General Hospital) between January 2019 and December 2019 were analyzed. We compared pain intensity with and without bowel manipulation during the HIFU treatment and evaluated tolerability without intravenous sedation. The presence of discomfort or pain during the HIFU procedure was evaluated using the visual analog scale (VAS). Results: A total of 86 women were included in this study. All women underwent HIFU therapy with the PRO-2008 system in the supine position for posterior wall uterine fibroids and/or adenomyosis. Thirty-seven women received pretreatment anal catheterization with a condom and 49 women were not subjected to bowel manipulation. All patients received pretreatment condom-catheter device were well tolerated during the procedure of bowel manipulation. During the HIFU procedure, the women who had received bowel manipulation experienced lower pain intensity, especially less sacrococcygeal pain (VAS score 1.56 ± 1.46 vs 2.89 ± 1.61), target region pain (1.54 ± 1.30 vs 2.53 ± 1.29), and radiating pain (0.13 ± 0.34 vs 0.41 ± 0.54), compared with the women without bowel manipulation. Conclusion: Bowel manipulation with anal catheterization before HIFU therapy for posterior wall uterine masses can be safely performed and is effective as a low risk intervention to aid in reducing potential HIFU complications related to nerve involvement.
format	article
author	Meng-Hsing Wu Yu Zhang Dexin Chen Ningbo Zhou Hui Li Lingling Peng Min-Syuan Huang Tsung-Cheng Kuo
author_facet	Meng-Hsing Wu Yu Zhang Dexin Chen Ningbo Zhou Hui Li Lingling Peng Min-Syuan Huang Tsung-Cheng Kuo
author_sort	Meng-Hsing Wu
title	Pretreatment bowel manipulation during ultrasound-guided high-intensity focused ultrasound therapy for posterior wall uterine masses
title_short	Pretreatment bowel manipulation during ultrasound-guided high-intensity focused ultrasound therapy for posterior wall uterine masses
title_full	Pretreatment bowel manipulation during ultrasound-guided high-intensity focused ultrasound therapy for posterior wall uterine masses
title_fullStr	Pretreatment bowel manipulation during ultrasound-guided high-intensity focused ultrasound therapy for posterior wall uterine masses
title_full_unstemmed	Pretreatment bowel manipulation during ultrasound-guided high-intensity focused ultrasound therapy for posterior wall uterine masses
title_sort	pretreatment bowel manipulation during ultrasound-guided high-intensity focused ultrasound therapy for posterior wall uterine masses
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/fe2094f0cd524edcb7bf03eb9cc70a95
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Pretreatment bowel manipulation during ultrasound-guided high-intensity focused ultrasound therapy for posterior wall uterine masses

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