Microwave Endometrial Ablation For Menorrhagia Research Articles

The outcomes of microwave endometrial ablation. The outcomes of microwave endometrial ablation for menorrhagia

The outcomes of microwave endometrial ablation. The outcomes of microwave endometrial ablation for menorrhagia

Microwave endometrial ablation for menorrhagia

Microwave endometrial ablation for menorrhagia

Microwave endometrial ablation for menorrhagia ; Analysis of efficacy, recurrence rate and complication of MEA

Microwave endometrial ablation for menorrhagia ; Analysis of efficacy, recurrence rate and complication of MEA

M473 MICROWAVE ENDOMETRIAL ABLATION FOR MENORRHAGIA WITH IN-OFFICE GYNECOLOGY IN JAPAN

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S682-S682 Poster presentations M473 MICROWAVE ENDOMETRIAL ABLATION FOR MENORRHAGIA WITH IN-OFFICE GYNECOLOGY IN JAPAN A. Tsuda, A. TsudaSearch for more papers by this authorE. Tsuda, E. TsudaSearch for more papers by this authorN. Tsuda, N. TsudaSearch for more papers by this author A. Tsuda, A. TsudaSearch for more papers by this authorE. Tsuda, E. TsudaSearch for more papers by this authorN. Tsuda, N. TsudaSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)61661-0AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S682-S682 RelatedInformation

Office gynecologyにおけるマイクロ波子宮内膜アブレーションによる過多月経の治療

Office gynecologyにおけるマイクロ波子宮内膜アブレーションによる過多月経の治療

Therapeutic outcomes and postoperative courses in microwave endometrial ablation for menorrhagia

Therapeutic outcomes and postoperative courses in microwave endometrial ablation for menorrhagia

Ultrasonically guided transcervical microwave myolysis for uterine myomas using a curved microwave applicator with a conic end

A microwave applicator 4 mm in diameter inducible into myoma without a guiding needle was newly developed. Using the applicator, a feasibility study of ultrasonically guided transcervical microwave myolysis for uterine myomas was performed. After completion of microwave endometrial ablation for menorrhagia, a newly developed microwave applicator with a conic end was transcervically introduced into the uterine cavity and inserted into the myoma tissue assisted by transabdominal ultrasonic guidance. Three patients waiting for microwave endometrial ablation for menorrhagia caused by myomas entered the study. In the 3 patients, the major part consisting of a submucous myoma 5.2 to 10.8 cm in size was necrotized. The myoma shrank by 42 to 78% in the following 3 months. Ultrasonically guided transcervical microwave myolysis using a 4 mm applicator with a conic end is feasible.

Transcervical microwave myolysis for uterine myomas assisted by transvaginal ultrasonic guidance

The effects of transcervical microwave myolysis at 2.45 GHz after microwave endometrial ablation for menorrhagia were examined in patients with myomas. A transcervical microwave irradiation system assisted by transvaginal ultrasonic guidance was developed. Ten patients waiting for microwave endometrial ablation for menorrhagia caused by myomas entered the study after complete informed consent was obtained. Their outcomes were examined at least 6 months after transcervical microwave myolysis using the system. After completion of microwave endometrial ablation, interstitial microwave irradiation was performed using a guiding needle set in a puncture adaptor attached to a transvaginal ultrasonic probe and a microwave applicator of 1.6 mm in diameter. Shrinkage of the myoma was measured at 3 months and > or =6 months after the operation. In nine patients with typical myomas, the major part consisting of a submucous or an intramural node 4.0-7.5 cm in size was necrotized. The typical myomas had shrunk by 41-68% at 3 months and 37-69% at > or =6 months after the operation. In one patient with a 6.8-cm cellular leiomyoma, necrosis was limited to the neighborhood of the applicator tip. Shrinkage was 17% at both 3 and 6 months. This patient required a second microwave endometrial ablation at 6 months to treat recurrent menorrhagia. None of the patients underwent hysterectomy after the treatment. No remarkable complications were encountered. Typical myomas shrink after microwave myolysis following microwave endometrial ablation. Transcervical microwave myolysis seems to be applicable as a low-invasive treatment for a typical myoma.

Transcervical microwave myolysis assisted by transvaginal ultrasonic guidance

Transcervical microwave myolysis assisted by transvaginal ultrasonic guidance for myomas was developed. Using the system, a feasibility study of microwave myolysis was performed. After completion of microwave endometrial ablation for menorrhagia, a 14 gauge guiding needle was transcervically introduced to the uterine cavity and inserted into the myoma tissue under ultrasonography using a transvaginal probe with a puncture attachment. An inner needle of the guiding needle was replaced by a microwave applicator 1.6 mm in diameter. Three submucous myoma nodes 5-7 cm in size were irradiated by microwaves at 2.45 GHz. Main part of the nodes became avascular in Gd-enhanced MRI after one month. Usual myoma nodes shrank by 44-53% at three months that followed. No severe complications were encountered during and after the operation. Ultrasonically guided microwave myolysis is feasible and a promising treatment.

Microwave endometrial ablation for menorrhagia caused by large submucous myomas

To examine the feasibility of microwave endometrial ablation (MEA), using a curved microwave applicator, in patients with menorrhagia caused by a submucous myoma greater than 3 cm in diameter, which is among the contraindications for conventional endometrial ablation. Patients included were refractory to medication, more than 45 years of age, and due to undergo hysterectomy to treat menorrhagia as a result of submucous myomas, although they hoped to avoid hysterectomy. Three patients underwent MEA at 2.45 GHz using a curved microwave applicator and microwave tissue coagulator to treat menorrhagia. Patients 1, 2 and 3 had submucous myoma nodes 4.5, 5.0 and 13 cm in diameter respectively. The applicator was guided under transabdominal ultrasonography to microwave irradiation sites arranged to cover the entire uterine lining based on preoperative magnetic resonance images. MEA was performed under general anesthesia or spinal anesthesia. Microwaves were irradiated at 40 W for 50 s for single irradiation sites. Patient 1 became amenorrheic after the second MEA, which was performed 2 months after the first operation. Patients 2 and 3 became amenorrheic after the first MEA. Postoperative abdominal pain was controllable by a suppository of non-steroidal anti-inflammatory drugs. The patients were discharged the day after the operation. No remarkable complications were encountered during or after surgery. Microwave endometrial ablation improves menorrhagia caused by large submucous myomas when the microwave applicator reaches all parts of the uterine cavity.

Microwave endometrial ablation for menorrhagia in patients with systemic disorders

Objective: To evaluate the effectiveness of microwave endometrial ablation (MEA) in the treatment of menorrhagia in patients with severe systemic disease or medical conditions. Methods: Forty-two menorrhagic women undergoing systemic disorders with failure of medical management were treated with MEA under local or general anesthesia, and were followed-up for 1 year. Results: The women had a mean age of 39.4 years (range, 17–49). The procedure was successfully completed in all patients, and no intraoperative complications occurred. Two cases died of their primary severe medical diseases within 2 months of treatment but these cases were not associated with MEA. Among the remaining 40 patients, 24 (60.0%) had amenorrhea within 12 months. The duration of hospitalization and the amount of blood transfusion were significantly reduced after treatment, and the quality of life of these patients was improved significantly. Conclusions: MEA is a safe and effective treatment for the management of severe menorrhagia in patients undergoing systemic illness or severe medical conditions.

Microwave endometrial ablation for menorrhagia: outcome at 2 years--experience of a district general hospital

One hundred and twenty-three women underwent microwave endometrial ablation (MEA) for the treatment of dysfunctional uterine bleeding (DUB). The mean age at treatment was 40.2 years and the average treatment time was 2 minutes 50 seconds. All patients stayed as day cases, except for two who stayed overnight, one due to pain and the other due to urinary retention. The follow-up was carried out at 6 months, 1 and 2 years, respectively. The success rate was 80%, 76% and 70% at 6 months and 1-year and 2-year follow-up. The patient satisfaction rate was 80%, 75% and 68% at 6 months, 1 year and 2 years, respectively. However, in women 45 years old and over the success rate was more than 90%, suggesting that MEA could be a preferred procedure for treatment of DUB in this age group compared to younger women, especially in those who do not benefit from the mirena intrauterine system or decline it. Approximately 70% of patients, who underwent hysterectomy due to the failure of treatment, had uterine/pelvic pathology in the form of adenomyosis, fibroid uterus or endometriosis; therefore prior to MEA, proper patient selection is vital. There were a few minor complications but no uterine perforation or emergency hysterectomies in the group studied.

婦人科領域におけるマイクロ波凝固療法の展開

Since microwave tissue coagulator became commercially available in 1982, it has been widely used for treating hepatomas. Some gynecologists did use the apparatus in laparoscopic salpingectomy for tubal pregnancy, tubal cautery for sterilization, and hemostasis during biopsies of the ovary and commented on its usability. However, gynecologists effectively forgot about microwave coagulation therapy until a 1995 report of microwave endometrial ablation for menorrhagia. Microwave coagulation therapy or microwave ablation therapy has gained recognition as a minimally invasive alternative to hysterectomy for menorrhagia, and recently a curved microwave applicator extended its indication. Menorrhagia in an enlarged distorted uterine cavity caused by myomas and adenomyosis is treatable by microwaves. In addition, atypical endometrial hyperplasia and early endometrial carcinoma are now within the scope of microwave ablation therapy.

Microwave endometrial ablation for menorrhagia caused by submucosal myomas

Microwave endometrial ablation for menorrhagia caused by submucosal myomas

Microwave endometrial ablation for menorrhagia

Sixteen women requesting surgical treatment of menorrhagia were recruited for a study on microwave endometrial ablation. The mean age at treatment was 41.4 years and all patients had completed their family and were pre-menopausal. Average treatment time was 2 minutes 6 seconds. All patients reported a reduction in their menstrual loss and 87.5% were satisfied with their treatment after 1 year follow-up. One patient required overnight admission for analgesia while 15 patients were treated on a day case basis using light general anaesthesia. Sixty-seven per cent of patients reported a reduction in dysmenorrhoea scores at 1 year, two patients reported no change in symptoms and one patient reported a modest increase. One patient had a hysterectomy 10 months after treatment despite being amenorrhoeic. The indication for hysterectomy was pelvic pain (which was present before endometrial ablation). There were few minor complications but no uterine perforation or emergency hysterectomies.