Radiofrequency Thermoablation of Submucosal Leiomyoma: A Preliminary Report on Health, Symptom and Quality of Life Outcomes

Abstract

Study Objective: Submucosal leiomyoma commonly causes abnormal uterine bleeding, menstrual abnormalities and infertility and is usually treated by hysteroscopy. However, not all submucosal leiomyomas can be treated by hysteroscopy; patients with high- scoring submucosal leiomyoma must undergo transabdominal myomectomy to preserve their uterus. Design: Premenopausal women with symptomatic uterine submucosal leiomyoma were included in this study. The pre- and postoperative myoma volumes were measured by 3D ultrasonography. The effect of symptoms on health-related quality of life (HRQL) was assessed using the Uterine Fibroids Symptom and Quality of Life questionnaire. Setting: Observational study. Patients: Premenopausal women with symptomatic leiomyoma. Intervention: myolysis with radiofrequency. Measurements and Main Results: Submucosal leiomyoma volume reduction rate was 75.5% ± 14.1% and 80.7 ± 22.1% 3 and 6 months after surgery, respectively. No differences were seen in the volume reduction rate according to the preoperative grade of leiomyoma. Symptom scores and HRQL scores showed improvements 18 months after surgery with no differences between grades. Penetration/burn injuries of the bowel or bladder, sepsis, shock, embolism and peritonitis were not reported. Conclusion: Transvaginal RF thermal ablation is a good treatment method for symptomatic submucosal leiomyoma, especially for patients with a high leiomyoma grade and when there is no choice for treatment except hysterectomy or hysterotomy.