A Randomized Controlled Trial of High-Intensity Focused Ultrasound versus Laparoscopic Myomectomy for Symptomatic Uterine Fibroids

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 277–288

DOI: 10.46882/2026/IJOG/000500

Original Research Article

Title: A Randomized Controlled Trial of High-Intensity Focused Ultrasound versus Laparoscopic Myomectomy for Symptomatic Uterine Fibroids

Names of Authors: Olayinka O. Cole¹, Nesta C. Chuka¹

Authors’ Affiliations:
¹ Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, National Hospital, Abuja, Nigeria

Abstract:
High-Intensity Focused Ultrasound (HIFU) represents a non-invasive thermal ablation technique expanding treatment options for uterine leiomyomas. This randomized controlled trial compared the clinical efficacy, improvement in quality of life, and safety profiles of ultrasound-guided HIFU versus standard Laparoscopic Myomectomy (LM) for symptomatic uterine fibroids. One hundred and forty premenopausal women with 1 to 3 symptomatic intramural fibroids (maximum diameter 5 to 9 cm) were randomized into two equal treatment arms (n = 70 per group). The primary outcomes checked at 12 months were the volume reduction rate of the primary fibroid and the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) score. At 12 months, the mean fibroid volume reduction rate was 62.4% ± 10.5% in the HIFU group, while the LM group achieved complete surgical removal (100%). Both interventions led to a significant, comparable improvement in the UFS-QOL symptom severity scores (p = 0.18). Crucially, the HIFU cohort experienced significantly shorter treatment and recovery times, with a median hospital stay of 6 hours compared to 48 hours for the LM group (p < 0.001). Major procedural complications (hemorrhage or pelvic infection) were absent in the HIFU group but occurred in 5.7% of the LM cohort (p = 0.041). Minor adverse events in the HIFU group included transient skin burns (2.9%) and mild pelvic pain. Non-invasive HIFU ablation offers clinical symptom relief and quality-of-life improvements comparable to laparoscopic myomectomy with fewer major complications and drastically reduced hospital stays.

Keywords: Uterine Fibroids; High-Intensity Focused Ultrasound; Laparoscopic Myomectomy; Symptom Severity; Quality of Life; Thermal Ablation.

Manuscript Timeline: Received: May 25, 2026; Revised: July 15, 2026; Accepted: August 04, 2026; Published: August 27, 2026.

Citation: Cole OO, Chuka NC. A Randomized Controlled Trial of High-Intensity Focused Ultrasound versus Laparoscopic Myomectomy for Symptomatic Uterine Fibroids. International Journal of Obstetrics and Gynecology. 2026; 14(8): 277–288.

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