{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:35:35Z","timestamp":1793212535182,"version":"4.5.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>High-intensity focused ultrasound (HIFU) has received increasing interest and application as a noninvasive modality for the local treatment of solid tumors. In this study, we aim to evaluate the efficacy of HIFU in rectocele and cystocele.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This clinical trial study was conducted on patients who have symptomatic grade 1 and 2 rectocele and cystocele. All patients randomized in two groups; one received HIFU therapy, and the other group underwent Kegel exercises on a daily basis. All patients were followed 2 and 6 months after intervention. The efficacy of HIFU therapy and Kegel exercises were measured based on the pelvic floor discomfort index questionnaire (PFDI-20) and Female Sexual Function Index (FSFI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Both Kegel exercises and HIFU improved the scores of all sections of FSFI and PFDI questionnaires (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value &lt; 0.05) significantly. Our data in comparison of Kegel exercises versus HIFU therapy showed no significant difference.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our data showed good results in both sexual function and urinocolorectal symptoms after HIFU therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/abr.abr_183_24","type":"journal-article","created":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:00:23Z","timestamp":1793210423000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of High-Intensity Focused Ultrasound in Urinary and Fecal Symptoms Caused by Rectocele and Cystocele"],"prefix":"10.4103","volume":"15","author":[{"given":"Maryam","family":"Hajhashemi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahereh","family":"Khalili","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minoo","family":"Movahedi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiva","family":"Taheri","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5]]},"reference":[{"key":"R1-20261028","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/978-3-319-22536-4_1","article-title":"HIFU tissue ablation: Concept and devices","volume":"880","author":"Ter Haar","year":"2016","journal-title":"Adv Exp Med Biol"},{"key":"R2-20261028","first-page":"5634","article-title":"High intensity focused ultrasound (HIFU)","volume":"18","author":"Barkin","year":"2011","journal-title":"Can J Urol"},{"key":"R3-20261028","doi-asserted-by":"crossref","first-page":"302","DOI":"10.3109\/02656736.2014.969789","article-title":"Emerging HIFU applications in cancer therapy","volume":"31","author":"Maloney","year":"2015","journal-title":"Int J Hyperthermia"},{"key":"R4-20261028","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.5009\/gnl.2010.4.S1.S57","article-title":"Current and future clinical applications of high-intensity 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Gynecol"},{"key":"R11-20261028","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1055\/s-0030-1254295","article-title":"Rectocele","volume":"23","author":"Beck","year":"2010","journal-title":"Clin Colon Rectal Surg"},{"key":"R13-20261028","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1080\/009262300278597","article-title":"The female sexual function index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function","volume":"26","author":"Rosen","year":"2000","journal-title":"J Sex Marital Ther"},{"key":"R14-20261028","doi-asserted-by":"crossref","first-page":"480","DOI":"10.5114\/ada.2021.107934","article-title":"The importance of use of the FSFI questionnaire in gynecology and venerology: A pilot study","volume":"38","author":"Jarz\u0105bek-Bielecka","year":"2021","journal-title":"Postepy Dermatol Alergol"},{"key":"R15-20261028","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1111\/j.1743-6109.2011.02553.x","article-title":"The female sexual function index: Translation and validation of an Iranian version","volume":"9","author":"Fakhri","year":"2012","journal-title":"J Sex Med"},{"key":"R16-20261028","doi-asserted-by":"crossref","first-page":"bmjopen","DOI":"10.1136\/bmjopen-2016-015415.208","article-title":"208: Translation and validation of the pelvic floor distress inventory short form (PFDI-20), Iranian version","volume":"7","author":"Hakimi","year":"2017","journal-title":"BMJ Open"},{"key":"R17-20261028","doi-asserted-by":"crossref","first-page":"510e1","DOI":"10.1016\/j.ajog.2018.01.033","article-title":"Structural, functional, and symptomatic differences between women with rectocele versus cystocele and normal support","volume":"218","author":"Berger","year":"2018","journal-title":"Am J Obstet 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Fourniere","year":"2024","journal-title":"IRBM"},{"key":"R21-20261028","doi-asserted-by":"crossref","first-page":"2295812","DOI":"10.1080\/02656736.2023.2295812","article-title":"US-guided high-intensity focused ultrasound in pancreatic cancer treatment: A consensus initiative between Chinese and European HIFU centers","volume":"41","author":"Zhou","year":"2024","journal-title":"Int J Hyperthermia"},{"key":"R22-20261028","doi-asserted-by":"crossref","first-page":"2310","DOI":"10.1007\/s00330-023-10253-7","article-title":"Efficacy of HIFU for the treatment of benign thyroid nodules: A systematic review and meta-analysis","volume":"34","author":"Fan","year":"2024","journal-title":"Eur Radiol"},{"key":"R23-20261028","first-page":"58","article-title":"Transvaginal high-intensity focused ultrasound (HIFU) for the treatment of urinary incontinence","volume":"18","author":"Suzuki","year":"2021","journal-title":"Jpn J Women Med Pelvic Floor"},{"key":"R24-20261028","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.urolonc.2019.09.001","article-title":"Prospective multicentre study using high intensity focused ultrasound (HIFU) for the focal treatment of prostate cancer: Safety outcomes and complications","volume":"38","author":"Schmid","year":"2020","journal-title":"Urol Oncol"}],"container-title":["Advanced Biomedical 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