Jonsdottir Gudny, Beermann Marie, Lanz Erika, Nikodell Ava, Cronsioe Annika, Hasselrot Klara, Kopp-Kallner Helena
Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden.
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2025 Feb;104(2):350-356. doi: 10.1111/aogs.15041. Epub 2024 Dec 19.
The objective of this study was to evaluate the effectiveness and acceptability of ultrasound guided microwave ablation for treating symptoms related to uterine fibroids.
This was a prospective interventional study. Patients with symptomatic uterine fibroids were included at Danderyd Hospital, Sweden, from January 2020 to August 2023. All patients were treated with percutaneous or vaginal ultrasound guided microwave ablation. Primary outcome was reduction of fibroid symptoms evaluated by the validated uterine fibroid symptom and quality of life (UFS-QoL) questionnaire at 6 months post-treatment. Location of each fibroid was noted. Secondary outcomes included reduction of menstruation blood loss, change in hemoglobin, ferritin and Anti-Müllerian hormone, fibroid volume difference, hospitalization, acceptability, and postoperative pain. Clinical trials registration number NCT04240262.
Symptoms from uterine fibroids decreased by 37% (p < 0.001) on the symptom severity scale and health-related quality of life increased by 74% (p < 0.001). Menstrual blood loss decreased by 38% (p < 0.001) according to the Pictorial Bleeding Assessment Chart and median fibroid shrinkage of the three largest treated fibroids was 64% (p < 0.001). Highest median shrinkage rate (82) was seen in submucous fibroids. A total of 110 of 113 (97%) patients left the hospital on the day of treatment. We experienced one adverse event (0.8%) Clavien Dindo grade 3. Acceptability was high and postoperative pain was mild to moderate.
Microwave ablation is a highly acceptable minimally invasive method for treating symptoms related to uterine fibroids in patients who desire uterus preservation. Submucosal fibroids showed more favorable treatment results.
本研究的目的是评估超声引导下微波消融治疗子宫肌瘤相关症状的有效性和可接受性。
这是一项前瞻性干预研究。2020年1月至2023年8月期间，瑞典丹德吕德医院纳入了有症状的子宫肌瘤患者。所有患者均接受经皮或经阴道超声引导下的微波消融治疗。主要结局是通过经过验证的子宫肌瘤症状与生活质量（UFS-QoL）问卷在治疗后6个月评估肌瘤症状的减轻情况。记录每个肌瘤的位置。次要结局包括月经失血减少、血红蛋白、铁蛋白和抗苗勒管激素的变化、肌瘤体积差异、住院情况、可接受性和术后疼痛。临床试验注册号NCT04240262。
在症状严重程度量表上，子宫肌瘤症状减轻了37%（p < 0.001），与健康相关的生活质量提高了74%（p < 0.001）。根据图片出血评估图表，月经失血量减少了38%（p < 0.001），三个最大治疗肌瘤的中位肌瘤缩小率为64%（p < 0.001）。黏膜下肌瘤的中位缩小率最高（82）。113例患者中有110例（97%）在治疗当天出院。我们经历了1例不良事件（0.8%），Clavien Dindo 3级。可接受性高，术后疼痛为轻至中度。
对于希望保留子宫的患者，微波消融是一种高度可接受的微创方法，用于治疗子宫肌瘤相关症状。黏膜下肌瘤显示出更有利的治疗结果。
