Systematic Review of Outcomes after Radiofrequency Ablation for Fibroids: An Aagl Practice Committee Evidence Review

Abstract

Study Objective To review the existing literature regarding short- and long-term outcomes after radiofrequency (RF) fibroid ablation. Design Systematic review. Setting N/A. Patients or Participants All studies that are comparative were included, and non-comparative studies with at least 10 participants per group, in any language, in any country/setting were included. Interventions We conducted a systematic review or all studies examining the use of RF ablation for the treatment of fibroids which reported clinical and patient-centered outcomes and complications. We searched existing systematic reviews and Medline, Embase, and Cochrane from inception through February 2, 2021. We included comparative and noncomparative studies of RF ablation and RF ablation compared to other interventions. Measurements and Main Results 7260 abstracts were doubly reviewed by members of the AAGL Practice Committee. Of these, 29 studies met inclusion criteria. 11 studies examined laparoscopic ultrasound guided RF ablation. 2 studies examined laparoscopic RF ablation (without imaging guidance). 5 studies examined percutaneous ultrasound guided RF ablation, 1 study examined percutaneous CT guided RF ablation, 6 studies examined transvaginal ultrasound guided RF ablation. 4 studies examined transcervical ultrasound guided RF ablation. Conclusion Worldwide, various types of radiofrequency fibroid ablation procedures are being performed for the treatment of symptomatic fibroids, including laparoscopic, percutaneous, transcervical and transvaginal routes, either with or without image guidance. Review of the available literature demonstrates that these procedures are associated with rare major complications and reintervention rates are low. Fibroid volume, bleeding, pain, bulk symptoms and overall quality of life improve after RF ablation. To review the existing literature regarding short- and long-term outcomes after radiofrequency (RF) fibroid ablation. Systematic review. N/A. All studies that are comparative were included, and non-comparative studies with at least 10 participants per group, in any language, in any country/setting were included. We conducted a systematic review or all studies examining the use of RF ablation for the treatment of fibroids which reported clinical and patient-centered outcomes and complications. We searched existing systematic reviews and Medline, Embase, and Cochrane from inception through February 2, 2021. We included comparative and noncomparative studies of RF ablation and RF ablation compared to other interventions. 7260 abstracts were doubly reviewed by members of the AAGL Practice Committee. Of these, 29 studies met inclusion criteria. 11 studies examined laparoscopic ultrasound guided RF ablation. 2 studies examined laparoscopic RF ablation (without imaging guidance). 5 studies examined percutaneous ultrasound guided RF ablation, 1 study examined percutaneous CT guided RF ablation, 6 studies examined transvaginal ultrasound guided RF ablation. 4 studies examined transcervical ultrasound guided RF ablation. Worldwide, various types of radiofrequency fibroid ablation procedures are being performed for the treatment of symptomatic fibroids, including laparoscopic, percutaneous, transcervical and transvaginal routes, either with or without image guidance. Review of the available literature demonstrates that these procedures are associated with rare major complications and reintervention rates are low. Fibroid volume, bleeding, pain, bulk symptoms and overall quality of life improve after RF ablation.