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Percutaneous Sonographically Guided Radiofrequency Ablation of Medium-Sized Fibroids: Feasibility Study

¹ Department of Radiology, University of Insubria, Viale Borri 57, 21100 Varese, Italy.
² Service of Anesthesiology, University of Insubria, Varese, Italy.
³ Department of Obstetrics and Gynecology, University of Verona, Verona, Italy.
⁴ Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.

OBJECTIVE. The purpose of this study was to assess the feasibility and safety of percutaneous radiofrequency ablation under sonographic guidance as a unique procedure in the management of symptomatic uterine myomas.

SUBJECTS AND METHODS. Six premenopausal women with symptomatic submucosal or intramural uterine myomas underwent percutaneous radiofrequency ablation under suprapubic sonographic guidance. Relief of symptoms and reduction in the diameter and volume of the myomas were measured every 3 months.

RESULTS. The location of myomas was anterior and submucosal in one of the six patients and intramural in the other five (one posterior, one anterior, two fundal, and one on the left side). Five of the patients had pelvic pain, and four had menorrhagia. The median baseline diameter was 4.8 cm (range, 4.4–5.2 cm), and the mean volume was 58.57 cm³ (range, 44.58–73.58 cm³). The mean follow-up time was 9 months (range, 3–12 months). At follow-up, the median diameter was 2.3 cm (range, 1.20–3.2 cm), and the median volume was 8.97 cm³ (range, 0.90–18.81 cm³). The median preoperative symptom score was 47.2 (31.8–67.30), and the median health-related quality of life (QOL) score was 63.92 (37.20–86.00). The median symptom score during follow-up was 5.15 (range, 0–26), and the mean QOL score was 96.2 (range, 86.30–100). Four of six patients were symptom-free at the last follow-up visit.

CONCLUSION. Percutaneous sonographically guided radiofrequency ablation alone is a feasible and efficient procedure in the management of medium-sized uterine myomas.

Keywords: radiofrequency thermal ablation • sonography • uterine myoma

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