Uterine fibroids and adenomyosis

Indications:

• a woman's desire to preserve the uterus;
  
• miscarriage due to the presence of myomatous nodes or adenomyosis;
  
• severe clinical symptoms with a woman's unwillingness to remove an organ.

Contraindications:

• weight more than 110 kg; the distance from the skin to the middle of the node exceeding the focal length (determined on the device, on the marking), as a rule, this distance is more than 20 cm;
  
• lack of clear node visualization; adhesion of intestinal loops to the node during the adhesive process; the presence of any nature formation in the ovaries and fallopian tubes;
  
• suspected pathological changes in the endometrium; the presence of a IUD; the presence of a note on a thin stalk; acute inflammatory diseases of any etiology.

Preoperative examination:

• Ultrasound (with a filled bladder and transvaginal);
  
• Contrast-enhanced MRI;
  
• standard gynecological examination with cytological smear analysis and flora analysis;
  
• if there is a suspicion of endometrial pathology on ultrasound, preliminary D&C is necessary, HIFU can be performed not earlier than 3 weeks after D&C;
  
• standard examination for neuroleptanalgesia or deep sedation (clinical blood test, clinical urine test, ECG, blood biochemistry, chest X-ray, blood serology, blood type and Rh factor).

Preparation:

• "water diet" for 3 days: there are pureed soups, broths, copious drinking, puree, pureed porridge;
  
• the goal is to flood the loops of the small intestine with liquid contents and expel air from the intestine;
  
• all products that cause bloating of the intestine are prohibited;
  
• three days of Espumisan 3-5 capsules 3 times a day, preferably liquid Espumisan 1 tablespoon 3 times a day; all products that cause bloating of the intestine are prohibited;
  
• the day before the procedure, Sumamed is prescribed 500 mg once a day, Metronidazole 500 mg three times a day;
  
• taking medications continues for another three days after the procedure;
  
• on the eve of the operation - shaving of the pubes and lower abdomen (important: do not scarify the skin!);
  
• immediately before the operation, catheterization of the bladder is performed with a three-way Foley catheter.