Ventral hernia after high-intensity focused ultrasound ablation for uterine fibroids treatment: A case report

BACKGROUND: High-intensity focused ultrasound (HIFU) ablation is a minimally invasive approach in gynecology that is used to manage uterine fibroids. Although this procedure is safe and effective, adverse outcomes are becoming a major problem. CASE SUMMARY: We present a case of ventral hernia that occurred as a rare and delayed complication of HIFU ablation for uterine fibroids treatment. The patient came to the hospital with abdominal bloating that occurred 6 mo after ultrasound-guided HIFU ablation for managing uterine fibroids. The ventral hernia, which occurred due to atrophied muscle layers following the procedure, was confirmed by imaging studies and intraoperative findings. She required a hernia repair with mesh and hysterectomy for definitive treatment of uterine fibroid. CONCLUSION: High-intensity ultrasound ablation should be performed only on appropriate candidates. Patients should be educated about potential complications of the procedure and the possibility of subsequent treatment. Post-procedural long-term follow-up for detecting delayed adverse effects is important.