Abstract
Purpose: To assess the safety, efficacy and effectiveness of percutaneous radiofrequency (RF) thermal ablation to reduce symptoms of uterine fibroids. Materials and Methods: 17 premenopausal women with symptomatic uterine fibroids despite conventional medical treatment were included. The assessment of symptoms and characteristics of fibroids by vaginal ultrasound, magnetic resonance imaging (MRI) and contrast enhanced ultrasound (CEUS) was performed before starting treatment and 6 months after the procedure. Successful treatment was clinically considered if patients reported a reduction in symptoms 6 months after RF myolysis. Successful treatment was also considered if the necrosis of the fibroid was greater than 50%, 6 months after treatment. Results: The baseline score on visual analogue scale (VAS) for dysmenorrhea and intermenstrual pain was 5.76 ± 3.31 and 3.0 ± 3.4, respectively. According to a score of 0 - 3, baseline bleeding during menstruation was 2.29 ± 0.92. Six months after RF myolysis, the VAS for dysmenorrhea was 2.75 ± 3.32 (p = 0.004), whereas for intermenstrual pain it was 1.38 ± 2.56 (p = 0.02). Menstrual bleeding was reduced to 1.13 ± 0.89 (p = 0.005). Clinical success of the treatment was evident in 11 (64.7%) of the 17 patients with a 95% CI [38.6%, 84.7%]. Fourteen patients underwent MRI monitoring 6 months post-myolysis. Compared to baseline fibroid volume, ultrasound and MRI volume were 57.38% and 79.66% six months after surgery, respectively. A total of 13 patients (92.86%) had radiological success from the treatment (95% CI [64.2%, 99.6%]). Conclusion: Since percutaneous RF myolysis reduces volume and symptoms of uterine fibroids, it may be considered as a valid treatment for symptomatic fibroids.
Highlights
Uterine fibroids are the most common tumourin women [1]-[3]
Inclusion criteria for this prospective study were: 1) patients older than 18 years of age with symptomatic uterine fibroids not controlled with medical treatment based on intrauterine devices (IUD) with levonorgestrel (LNG) and/or antifibrinolytics, 2) capable of understanding the risks and benefits of radiofrequency thermocoagulation and its advantages and disadvantages compared with surgery, 3) without further comorbidities and without contraindication to sedation or loco-regional anaesthesia, 4) No response to pharmacological treatment
The location of the fibroids was in 5 cases (29.4%) anterior, in 2 (11.7%) cases posterior, in 6 cases (35.3%) fundic, in 2 cases (11.7%) in right side and in 2 cases (11.7%) in the right horn
Summary
Uterine fibroids are the most common tumourin women [1]-[3]. Up to 80% women will have at least one leiomyoma [2]. These monoclonal tumours arise from the uterine smooth-muscle tissue and depend on oestrogen and progesterone [2]. A single genetic hit might lead clonal expansion of stem cells within the normal myometrium [2]. Most uterine fibroids are asymptomatic [1]. Up to half women with symptomatic fibroids present significant clinical symptoms, including excessive uterine bleeding, dysmenorrhoea, intermenstrual pain, pelvic discomfort, infertility and consequent reduction in quality of life [1]-[5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
