Abstract
Objective
To assess the efficacy of Uterine Myoma Position-based Radiofrequency Ablation (UMP-b
RFA) at 36 months. An analysis of a new uterine fibroid ablation technique that allows
personalized access of delivering radiofrequency energy (transvaginal, hysteroscopic
or laparoscopic) based on myoma localization.
Study Design
Prospective observational cohort study in a community-based secondary care medical
center enrolled 61 premenopausal women with 112 symptomatic uterine myomas. 112 fibroids
were ablated in 5 ways with single or combined accesses: 82 Vaginal Ultrasound (VU)-guided
RFA, 19 Laparoscopic (L)-RFA, 5 Hysteroscopic (H)-RFA, 5 VU+H-RFA, and 1 VU+L-RFA.
The primary endpoint of this study was to evaluate the 3-year clinical outcome of
UMP-b RFA. The secondary endpoint was the possible identification of predictors of
its success. The outcomes evaluated at 12, 24, and 36 months after UMP-b RFA were
myoma size, type of symptomatology suffered, quality of life based on the “Uterine
Fibroid Symptom and Quality of Life” questionnaire, and interviews on the degree of
satisfaction with this surgery. The reintervention and complication rates were also
recorded and analyzed.
Results
Fibroids volume and diameter were significantly reduced by −90.2 % / −55.7 % at 36 months
post-intervention (p < 0.001) and the reduction of Symptom Severity scores was −71.8 %
three years after UMP-b RA (p < 0.001). The overall improvement in the quality of
life was demonstrated by an increase in the Quality-of-Life score of + 26.0 % at the
third follow-up (p < 0.001). 88.5 % of the patients interviewed would have the surgery
done again if they went back in time. The reintervention rate was 10/61 (16.4 %):
3 hysterectomies, 3 myomectomies, 3 operative hysteroscopies and 1 VU-RFA reoperation.
In this group of unsuccessful surgeries, the mean diameter of the dominant myomas
was found to be greater than that of the successes (5.3 vs 4.4 cm.). Out of the 61
cases, no major complications occurred, and the 2 minor complications observed were
self-limiting.
Conclusion
Uterine Myoma Position-based Radiofrequency Ablation is a safe, effective, and minimally
invasive solution for the treatment of symptomatic fibroids. Indeed, these clinical
outcome data at 36 months shows how UMP-b RFA can treat the symptomatology of uterine
fibromatosis. Hysterectomies or myomectomies were successfully avoided in more than
80 % of women bearing myomas with an average diameter of less than 5 cm.
Keywords
Abbreviation:
RFM (RadioFrequency Myolysis)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 06, 2022
Accepted:
December 4,
2022
Received in revised form:
November 1,
2022
Received:
June 2,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
