Comparative efficacy of focused ultrasound on hR-HPV clearance in premenopausal versus postmenopausal women: a retrospective cohort study.

OBJECTIVE

This study focused on determining the clearance rate of high-risk human papillomavirus (HR-HPV) with chronic cervicitis or squamous intraepithelial lesion following focused ultrasound (FUS) in premenopausal and postmenopausal women.

METHODS

From March 2022 to December 2024, clinicopathological data of 124 women, including 67 premenopausal patients and 57 postmenopausal counterparts who received FUS treatment, were gathered. The cumulative HR-HPV clearance rate served as an evaluation metric for treatment effectiveness. By employing the logistic regression analysis model, influencing variables of HR-HPV clearance were determined. The HR-HPV clearance efficacy following FUS surgery in both premenopausal and postmenopausal groups was analyzed by the Kaplan-Meier method, with log-rank test being used for assessing heterogeneities of outcomes between two groups.

RESULTS

After FUS surgery, the HR-HPV clearance rates were 70.1% and 76.1% in postmenopausal and premenopausal groups separately, with no significant difference (χ2=0.557, p = 0.455). Meanwhile, the median HR-HPV clearance time in premenopausal and postmenopausal women was 10.6 months (95% confidence interval (CI): 8.185-12.189) and 12.6 months (95% CI: 7.758-17.497), and the difference was not significant (log-rank test p = 0.455). As revealed by multivariate logistic regression, HPV16/18 genotype (OR = 4.99, p = 0.004) and cervical intraepithelial neoplasia(CIN)pathology (OR = 6.67, p = 0.045) were the independent predictors of clearance following FUS surgery, and they did not have any significant effect of menopausal status.

CONCLUSIONS

FUS demonstrates equivalent safety and efficacy in the treatment of HR-HPV infections in premenopausal and postmenopausal patients, with potential benefits in enhancing the clearance rates of persistent HPV16/18 infections. Yet further research is warranted for verification.