Ultrasound-guided transvaginal radiofrequency myolysis for symptomatic uterine myomas.

OBJECTIVE

To investigate the feasibility, efficacy and safety of ultrasound-guided transvaginal radiofrequency myolysis for symptomatic uterine myomas.

STUDY DESIGN

Forty-six premenopausal women with symptomatic uterine myomas received ultrasound-guided transvaginal radiofrequency myolysis as an outpatient procedure. Outcomes were assessed by measuring myoma volume at baseline and at 3-, 6- and 12-month follow-up; and by calculating the myoma volume reduction rate. Clinical improvement was assessed by calculating the menorrhagia score, the symptom severity score and the health-related quality-of-life score (Uterine Fibroids Symptom and Health-related Quality-of-life Questionnaire) before and after myolysis.

RESULTS

The mean age of patients was 40.8 [standard deviation (SD) 6.5] years. The mean diameter of the dominant myoma at baseline was 4.8 (SD 1.1) cm and the mean volume of the dominant myoma at baseline was 67.4 (SD 51.1)cm(3). The size of the myoma decreased gradually and an overall volume reduction rate of 83.0% was achieved at 12-month follow-up. The mean symptom severity score decreased and mean health-related quality-of-life score increased; the Uterine Fibroids Symptom and Health-related Quality-of-life Questionnaire showed a significant clinical improvement after myolysis compared with baseline (p<0.001). The menorrhagia score decreased significantly from baseline (p<0.05), showing an improvement in menorrhagia at 3-, 6- and 12-month follow-up. No major complications were observed or reported. The re-operation rate was 8.7%. Fifteen and eighteen months after myolysis, two patients delivered infants with no complications during or after delivery.

CONCLUSION

Ultrasound-guided transvaginal radiofrequency myolysis may be a safe, effective and minimally invasive outpatient procedure for the treatment of symptomatic uterine myomas.