Evaluation of High Intensity Focused Ultrasound (HIFU) in the Treatment of Rectal Endometriosis

Inclusion criteria

• Patients aged at least 25 years-old
• Rectal endometriosis in preoperative imaging, without other digestive locations (colon, ileum and small intentine)
• Symptomatic patient refusing hormonal treatment and/or surgery.
• Endometriosic nodule visible on echography with contrast and confirmed in Gadolinium MRI and difusion sequence (according to standardized protocol)
• Nodule with intrarectal protrusion of less than 50% (allowing the positioning of the probe in front of the rectal nodule)
• Distance from the upper pole to the anal margin ≤ 15 cm (measurement by MRI with intra-rectal contrast)
• No curent pregnancy (negative BHCG <72h before the HIFU procedure) and no pregnancy project within 6 months after the HIFU procedure (post-treatment MRI delay)
• Patient agreeing not to change her hormone treatment for the duration of the study.
• Patient accepting the study constraints
• Health insurance affiliated patient or beneficiary of an equivalent coverage

Exclusion criteria

• Virgin patient
• Ongoing uro-genital infection
• Anorectal anatomy incompatible with HIFU therapy
• History of segmental rectal resection with mechanical anastomosis, shaving or discoid resection
• Patient with an implant within 1cm of the treatment area (stent, catheter, ESSURE® contraceptive implants).
• Inflammatory colon disease (ulcerative colitis, Crohn's disease and others)
• Latex allergy
• Patient with contraindications to MRI
• Patient with contraindications to Gadolinium injection
• Patient previously treated with HIFU for a rectal endometriotic lesion
• Patient not speaking nor reading French
• Patient deprived of liberty following a legal or administrative decision
• Patient under guardianship or tutelage measure