High intensity focused ultrasound treatment for non-neoplastic epithelial disorders of the vulva: Factors affecting effectiveness and recurrence

Objective: This paper investigates the effectiveness of high-intensity focused ultrasound (HIFU) for treating non-neoplastic epithelial disorders of the vulva (NNEDV) and to analyse the factors that affect the effectiveness of HIFU and recurrence. Methods: This study included a total of 950 patients with pathologically confirmed NNEDV, who underwent HIFU treatment in our hospital between August 2008 and June 2013 and had completed follow-up data. Treatment efficacy and recurrence were evaluated retrospectively by analysing the patients' clinical pathological data and by following up their symptomatic changes. We also explored factors including age, status of menopause, HPV infection, lesion size, pathological type, and symptom severity for their correlation with treatment effectiveness and recurrence. Results: HIFU was effective in alleviating symptoms and improving vulva signs, with a cure rate of 42.2%, an effective rate of 56.1%, and a low recurrence rate of 9.4%. No severe complications were recorded during or after the treatment. The treatment was statistically more effective in younger patients with squamous hyperplasia and smaller lesions than in older patients with lichen sclerosus and larger lesions (P<0.05). Patients with a longer disease course or with lichen sclerosus had significantly higher recurrence rates than those with a shorter disease course or with squamous hyperplasia (P<0.05). Conclusions: HIFU is safe and effective in treating NNEDV. Its effectiveness is correlated with age, size of lesion and pathological type, whereas post-treatment recurrence rates may be related to the duration of the disease and the pathological sub-types.