This study was aim to evaluate the effects of High-intensity focused ultrasound (HIFU) ablation of uterine fibroids on genitourinary symptoms after HIFU therapy .

Seventy- five women with symptomatic uterine fibroid were scheduled for high-intensity focused ultrasound ablation for uterine fibroids. All subjects were required to perform Magnetic Resonance Imaging on Uterus in order to screen out the patients with endometrial or uterine malignancy before starting the treatment. Magnetic Resonance Imaging on Uterus follow up was also conducted three -month post HIFU therapy to assess the uterine reduction rate and fibroid reduction rate. Laboratory examination with Serum LDH, CA125 and Hemoglobin level were also performed before and three months post HIFU treatment. Genitourinary symptoms questionnaire assessment using Overactive Bladder Symptom Score (OABSS), Urogenital Distress Inventory-6 (UDI-6),  Incontinence Impact Questionnaire -7 ( IIQ-7) , International Consultation on Incontinence Questionnaire - Short Form( ICIQ-SF) , sexual function assessment with  Female Sexual Function Index ( FISI) questionnaire were also conducted before and three months post HIFU treatment.

Among these seventy- five patients, forty -five of them presented with anterior wall uterine fibroids while thirty of them had posterior wall uterine fibroids. For the treatment result , the average sonication power was 364.52 Watt while the average total treatment time was 115.36 minutes. Total Sonication time during HIFU therapy was 919.48s with average exposure energy was 338534.27 Joule . There was a significant improvement in uterine reduction rate (27.1 ± 15.2%, P<0.05) and fibroid reduction rate (40.68±23.85 %, P<0.05) after three month HIFU treatment through Uterus  Magnetic Resonance Imaging follow up .In comparison ,there was an increase in hemoglobin level and greater reduction in serum LDH and CA125 level at baseline and three months post HIFU treatment , with no significantly difference (P>0.05) . Symptomatic improvement in genitourinary symptoms with total reduction in OABSS, UDI-6, IIQ-7, ICIQ-SF score were found postoperatively (P<0.05). The scores of all parameters of FSFI improved significantly after HIFU therapy (P<0.05) except in the satisfaction and pain domain. In comparison between anterior wall uterine fibroids located group and non-anterior wall located group, the result showed that there was no significant difference in OABSS, UDI-6,IIQ-7 ,ICIQ-SF scores.

Successful ablation of the uterine fibroids in HIFU therapy  cause  shrinkage of the uterine size and uterine fibroids. Less compression effects of these uterine fibroids over pelvic organ and bladder after ablation therapy subsequently relieve the patients' lower urinary tract symptoms .

High-intensity focused ultrasound (HIFU) ablation treatment for uterine fibroids showed significant improvement in uterine reduction rate, fibroid reduction rate after HIFU treatment .HIFU treatment also has great impact in quality of life with improvement in genitourinary symptoms and sexual function.