Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Aug 21;37(6):947-956.
doi: 10.1080/08998280.2024.2387497. eCollection 2024.

A systematic review of the side effects of high-intensity focused ultrasound ablation of uterine fibroids

Mostafa Maged Ali  1 , Chileshe Raphael Mpehle  2   3 , Esther Olusola  2   3 , Phuti Khomotso Ratshabedi  2   3 , Ahmed Ragab Shehata  4 , Mohamed Ashraf Youssef  4 , Ebtehal Ali Helal Farag  5
Affiliations
Review

A systematic review of the side effects of high-intensity focused ultrasound ablation of uterine fibroids

Mostafa Maged Ali et al. Proc (Bayl Univ Med Cent). .

Abstract

Background: A new intervention called high-intensity focused ultrasound (HIFU) targets fibroids with high-intensity ultrasound pulses using ultrasound probes. This noninvasive method, which can be carried out with either magnetic resonance imaging or ultrasound guidance, results in immediate coagulated necrosis within a clearly defined area a few millimeters in diameter.

Methods: This systematic review evaluated the safety of HIFU in the treatment of uterine fibroids regardless of site or size. We specifically aimed to determine the incidence of side effects that can occur during and after HIFU. We searched the PubMed, Scopus, ScienceDirect, and Mendeley archive using only the terms HIFU and fibroid. After identifying 1077 studies of different types from 2014 to March 2024, 300 studies were screened and 60 included.

Results: According to Society of Interventional Radiology guidelines, class A adverse events (AEs) showed no significant results, and individuals with these AEs required no treatment and had no long-term consequences. Similarly, there were no class B significant results. However, 3943 of 10,204 patients (38%) complained of lower abdominal pain after the procedure, a class B AE, which resolved by analgesics. Further, 153 of 24,700 patients (0.6%) had skin burns, blisters, or nodules, and these issues resolved with conservative treatment. Additionally, 74 of 23,741 patients (0.3%) had hematuria; 882 of 5970 patients (14.7%) had abnormal vaginal discharge; 414 of 23,449 (1.7%) had vaginal bleeding; and 267 of 7598 (3.5%) had leg paresthesia. Major AEs (class C and D) were almost nonexistent, and the incidence of death in our study was zero.

Conclusion: HIFU ablation of uterine fibroids is generally safe, causing mostly mild side effects and very few severe complications. The relative safety of HIFU compared to other minimally invasive techniques, such as uterine artery embolization, still needs further evaluation.

Keywords: Adverse reaction; HIFU; high-intensity focused ultrasound; uterine fibroids.

PubMed Disclaimer

Conflict of interest statement

The authors report no funding or conflicts of interest.

Figures

Figure 1.
Figure 1.
Risk of bias assessment.
Figure 2.
Figure 2.
Forest plot for lower abdominal pain.
Figure 3.
Figure 3.
Forest plot for hematuria.
Figure 4.
Figure 4.
Forest plot for abnormal vaginal discharge.
Figure 5.
Figure 5.
Forest plot for skin burns, blisters, or nodules.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Sabry M, Al-Hendy A.. Medical treatment of uterine leiomyoma. Reprod Sci. 2012;19(4):339–353. doi:10.1177/1933719111432867. - DOI - PMC - PubMed
    1. Stewart EA. Uterine fibroids. N Engl J Med. 2015;372(17):1646–1655. doi:10.1056/NEJMcp1411029. - DOI - PubMed
    1. Stewart EA, Rabinovici J, Tempany CMC, et al. . Clinical outcomes of focused ultrasound surgery for the treatment of uterine fibroids. Fertil Steril. 2006;85(1):22–29. doi:10.1016/j.fertnstert.2005.04.072. - DOI - PubMed
    1. Chen YH, Lin HC, Chen SF, Lin HC.. Increased risk of preterm births among women with uterine leiomyoma: a nationwide population-based study. Hum Reprod. 2009;24(12):3049–3056. doi:10.1093/humrep/dep320. - DOI - PubMed
    1. ACOG Practice Bulletin No. 228 . Management of symptomatic uterine leiomyomas: correction. Obstet Gynecol. 2021;138(4):683–683. doi:10.1097/AOG.0000000000004557. - DOI - PubMed

LinkOut - more resources