Niddam Raphael, Netter Antoine, Courbière Blandine, Agostini Aubert, Miquel Laura
AP-HM Department of Obstetrics, Gynecology and Reproductive Medicine, "Women, Parents and Children Unit", La Conception University Hospital, 147 bd Baille, 13005, Marseille, France.
Aix Marseille University, CNRS, IRD, Avignon University, IMBE, Marseille, France.
Arch Gynecol Obstet. 2025 Sep;312(3):959-967. doi: 10.1007/s00404-025-08082-8. Epub 2025 Jun 28.
To evaluate the effectiveness of multi-bipolar radiofrequency ablation compared to standard laparoscopic myomectomy in treating uterine fibroids, focusing on women's quality of life.
Retrospective observational cohort study.
La Conception Hospital, APHM-Marseille, France.
50 women with symptomatic fibroids treated between December 2021 and December 2023.
Laparoscopic radiofrequency ablation or conventional laparoscopic myomectomy.
After excluding patients who did not complete the preoperative quality-of-life questionnaire, 34 underwent myomectomy and 16 radiofrequency ablation. At 3 months, no significant differences were observed in HRQOL improvement (9.2 ± 34.3 vs 24.2 ± 28.2, p = 0.14), SSS (- 27.5 ± 31.5 vs - 23.3 ± 33, p = 0.66), or FSFI (0.9 ± 14.7 vs - 1.5 ± 10.8, p = 0.40). The 6-month outcomes also showed no significant difference. Baseline fibroid-specific quality of life was significantly and negatively associated with improvement (p < 0.05).
Both procedures improved quality of life and reduced fibroid-related symptoms at 3 and 6 months, with no significant difference. Myolysis showed fewer peri- and postoperative complications, suggesting a better safety profile and potential as a conservative treatment option.
The ethics committee of Aix Marseille University approved this study on April 18, 2024, under the reference number 2024-04-18-08.
评估多极射频消融术与标准腹腔镜子宫肌瘤切除术在治疗子宫肌瘤方面的有效性，重点关注女性的生活质量。
回顾性观察队列研究。
法国马赛阿菲姆-马赛的拉孔ception医院。
2021年12月至2023年12月期间接受治疗的50例有症状子宫肌瘤女性。
腹腔镜射频消融术或传统腹腔镜子宫肌瘤切除术。
在排除未完成术前生活质量问卷的患者后，34例接受了子宫肌瘤切除术，16例接受了射频消融术。在3个月时，健康相关生活质量改善情况（9.2±34.3 vs 24.2±28.2，p = 0.14）、性功能评分（-27.5±31.5 vs -23.3±33，p = 0.66）或性功能指数（0.9±14.7 vs -1.5±10.8，p = 0.40）均未观察到显著差异。6个月的结果也显示无显著差异。基线时肌瘤特异性生活质量与改善情况显著负相关（p < 0.05）。
两种手术在3个月和6个月时均改善了生活质量并减轻了肌瘤相关症状，无显著差异。肌溶解术的围手术期和术后并发症较少，表明其安全性更好，有作为保守治疗选择的潜力。
艾克斯-马赛大学伦理委员会于2024年4月18日批准了本研究，参考编号为2024-04-18-08。
