Transvaginal ultrasound-guided radiofrequency myolysis for uterine myomas.
ABSTRACT Myolysis is one of the procedures that is claimed to provide significant improvement in myoma status without hysterectomy. Myolysis procedures have been generally performed via laparoscopy, and there are limited data on transvaginal radiofrequency (RF) myolysis. This study investigated the feasibility, efficacy and safety of transvaginal ultrasound-guided RF myolysis.
Transvaginal ultrasound-guided RF myolysis was performed on 69 premenopausal women with symptomatic uterine myomas as an outpatient procedure. Outcomes were assessed 1, 3, 6 and 12 months after RF myolysis. Myoma volumes were measured by ulrasonography. Menorrhagia was evaluated by the number of soaked normal-sized sanitary products used per menstrual period and overall symptoms were evaluated using the symptom severity subscale of the uterine fibroids symptom questionnaire.
Mean (± SD) age of patients was 39.8 ± 6.5 years. Mean baseline volume of the dominant myomas was 304.6 ± 229.1 cm(3) and its volume at 3 months following RF myolysis decreased compared with the previous examination (P = 0.002). An improvement of menorrhagia occurred 1, 3, 6 and 12 months after operation (all P < 0.001 versus baseline). Overall symptoms at 1, 3, 6 and 12 months after RF myolysis also improved (all P < 0.001 versus baseline). No major complications were observed or reported. After 12 months, three patients had successfully conceived and delivered and there were no complications during labor or delivery.
Transvaginal ultrasound-guided RF myolysis might be a safe, effective and minimally invasive outpatient procedure for uterine myoma in terms of size reduction, symptom improvement and safety.
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ABSTRACT: Laparoscopic myomectomy can be carried out in cases of subserosal and intramural fibroids. Laparoscopic myolysis can be proposed as an alternative to laparoscopic myomectomy in cases of large or multiple intramural fibroids in women aged over 40 or not desiring to bear more children but wishing to avoid a future hysterectomy. The authors report the technique and the long-term results in a series of 48 women with fibroids treated by myolysis. Because of the risk of bowel adhesions, further studies with another type of laser fiber are required.Journal of Gynecologic Surgery 02/1993; 9(2):95-9.