TITLE:
Percutaneous Ultrasound-Guided Radiofrequency Thermal Ablation for Treatment of Uterine Fibroids
AUTHORS:
Raúl García Marcos, Javier Monleón, Alicia Martínez-Varea, Fernando Gómez, Guillermina Montoliú, Jose J. Martínez, Luis Martí-Bonmatí, Antonio Pellicer
KEYWORDS:
Percutaneous Radiofrequency Thermal Ablation, Myolysis, Uterine Fibroids
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.12,
August
28,
2014
ABSTRACT: Purpose: To assess the
safety, efficacy and effectiveness of percutaneous radiofrequency (RF) thermal
ablation to reduce symptoms of uterine fibroids. Materials and Methods: 17
premenopausal women with symptomatic uterine fibroids despite conventional
medical treatment were included. The assessment of symptoms and characteristics
of fibroids by vaginal ultrasound, magnetic resonance imaging (MRI) and contrast
enhanced ultrasound (CEUS) was performed before starting treatment and 6 months
after the procedure. Successful treatment was clinically considered if patients
reported a reduction in symptoms 6 months after RF myolysis. Successful
treatment was also considered if the necrosis of the fibroid was greater than
50%, 6 months after treatment. Results: The baseline score on visual analogue
scale (VAS) for dysmenorrhea and intermenstrual pain was 5.76 ± 3.31 and 3.0 ±
3.4, respectively. According to a score of 0 - 3, baseline bleeding during
menstruation was 2.29 ± 0.92. Six months after RF myolysis, the VAS for
dysmenorrhea was 2.75 ± 3.32 (p = 0.004), whereas for intermenstrual pain it
was 1.38 ± 2.56 (p = 0.02). Menstrual bleeding was reduced to 1.13 ± 0.89 (p =
0.005). Clinical success of the treatment was evident in 11 (64.7%) of the 17
patients with a 95% CI [38.6%, 84.7%]. Fourteen patients underwent MRI
monitoring 6 months post-myolysis. Compared to baseline fibroid volume,
ultrasound and MRI volume were 57.38% and 79.66% six months after surgery,
respectively. A total of 13 patients (92.86%) had radiological success from the
treatment (95% CI [64.2%, 99.6%]). Conclusion: Since percutaneous RF myolysis
reduces volume and symptoms of uterine fibroids, it may be considered as a
valid treatment for symptomatic fibroids.