Safety of MR-guided focused ultrasound treatment of pedunculated subserosal uterine leiomyomas

Background: There has previously been a concern about whether it is safe to use minimally invasive methods to treat pedunculated subserosal uterine leiomyomas. The purpose of our study is to evaluate the safety of magnetic resonance-guided focused ultrasound (MRgFUS) ablation of pedunculated subserosal uterine leiomyomas. Methods: All cases of MRgFUS ablations performed at our institution from March 2005 through March 2010 were reviewed to identify patients in whom a pedunculated subserosal leiomyoma was treated. Follow-up clinical and surgical data were reviewed to assess for complications. Results: A pedunculated leiomyoma was treated in 11 of 179 patients. Only two of the 11 patients had complications, both of which were minor and likely unrelated specifically to the pedunculated leiomyomas. One patient had transient lumbar plexopathy contralateral to the pedunculated leiomyoma, and one patient had transient voiding difficulty. Operative findings in three other patients who subsequently had myomectomy or hysterectomy found no adhesions or other complications related to the pedunculated leiomyomas. Conclusions: Pedunculated subserosal leiomyomas are not a contraindication to treatment by MRgFUS. We found no evidence of complications specifically related to pedunculated subserosal leiomyomas.