Focused ultrasound versus LEEP for high-grade squamous intraepithelial lesions: a retrospective cohort study of long-term effectiveness and obstetric outcomes
- 1Department of Gynecology and Obstetrics, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- 2North Sichuan Medical College, Nanchong, China
- 3State Key Laboratory of Ultrasound in Medicine and Engineering College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
Abstract
Introduction To compare long-term effectiveness and obstetric outcomes of focused ultrasound (FU) ablation versus loop electrosurgical excision procedure (LEEP) for high-grade squamous intraepithelial lesions (HSIL) in reproductive-aged women.Materials and methods This retrospective cohort included women treated with FU (n = 29) or LEEP (n = 32) for HSIL who subsequently delivered (2017–2023). A control group (n = 61) comprised healthy women with negative preconception HR-HPV/cytology. Outcomes were cumulative HR-HPV clearance, cervical length, pregnancy outcomes.Results Both FU and LEEP demonstrated comparable long-term effectiveness: cumulative HR-HPV clearance rates did not differ significantly at any time point (p > 0.05). Post-intervention cervical length was significantly shorter in the LEEP group (24.79 ± 3.98 mm) than in both the FU (27.63 ± 2.80 mm) and control (28.26 ± 3.92 mm) groups (p = 0.003). Cervical insufficiency was more frequent in the LEEP group (15.63%) than in the FU (3.45%) and control (1.64%) groups (p = 0.019). The LEEP group also had higher rates of preterm birth (18.75% vs 3.45% in FU and 4.92% in controls; p = 0.039) and lower rates of vaginal delivery (15.63% vs 44.83% in FU; p = 0.025).Conclusion In this selected cohort of women with successful live births, FU may have comparable long-term effectiveness to LEEP for HSIL while potentially preserving cervical length and reducing adverse obstetric risks. These preliminary findings suggest FU may be a fertility-sparing option for appropriately selected HSIL women who are planning pregnancy.
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BibTeX
@article{zhang2026focused,
title = {{Focused ultrasound versus LEEP for high-grade squamous intraepithelial lesions: a retrospective cohort study of long-term effectiveness and obstetric outcomes}},
author = {Miao Zhang and Fei Long and Yujuan Liu and Qiao Jing and Jiaojiao Ren and Liming Chen and Chenzhi Li and Qiuling Shi and Honggui Zhou},
journal = {International Journal of Hyperthermia},
year = {2026},
month = oct,
doi = {10.1080/02656736.2026.2749296},
url = {https://doi.org/10.1080/02656736.2026.2749296},
note = {CC BY},
}
RIS
TY - JOUR
TI - Focused ultrasound versus LEEP for high-grade squamous intraepithelial lesions: a retrospective cohort study of long-term effectiveness and obstetric outcomes
AU - Miao Zhang
AU - Fei Long
AU - Yujuan Liu
AU - Qiao Jing
AU - Jiaojiao Ren
AU - Liming Chen
AU - Chenzhi Li
AU - Qiuling Shi
AU - Honggui Zhou
PY - 2026
DA - 2026/10/31
JO - International Journal of Hyperthermia
DO - 10.1080/02656736.2026.2749296
UR - https://doi.org/10.1080/02656736.2026.2749296
AB - Introduction To compare long-term effectiveness and obstetric outcomes of focused ultrasound (FU) ablation versus loop electrosurgical excision procedure (LEEP) for high-grade squamous intraepithelial lesions (HSIL) in reproductive-aged women.Materials and methods This retrospective cohort included women treated with FU (n = 29) or LEEP (n = 32) for HSIL who subsequently delivered (2017–2023). A control group (n = 61) comprised healthy women with negative preconception HR-HPV/cytology. Outcomes were cumulative HR-HPV clearance, cervical length, pregnancy outcomes.Results Both FU and LEEP demonstrated comparable long-term effectiveness: cumulative HR-HPV clearance rates did not differ significantly at any time point (p > 0.05). Post-intervention cervical length was significantly shorter in the LEEP group (24.79 ± 3.98 mm) than in both the FU (27.63 ± 2.80 mm) and control (28.26 ± 3.92 mm) groups (p = 0.003). Cervical insufficiency was more frequent in the LEEP group (15.63%) than in the FU (3.45%) and control (1.64%) groups (p = 0.019). The LEEP group also had higher rates of preterm birth (18.75% vs 3.45% in FU and 4.92% in controls; p = 0.039) and lower rates of vaginal delivery (15.63% vs 44.83% in FU; p = 0.025).Conclusion In this selected cohort of women with successful live births, FU may have comparable long-term effectiveness to LEEP for HSIL while potentially preserving cervical length and reducing adverse obstetric risks. These preliminary findings suggest FU may be a fertility-sparing option for appropriately selected HSIL women who are planning pregnancy.
SN - 1464-5157
SN - 0265-6736
ER -