Laparoscopic radiofrequency thermal ablation for uterine adenomyosis

Abstract

Background and Objectives:Symptomatic uterine adenomyosis, unresponsive to medical therapy, is a challenging condition for patients who desire to preserve their uterus. This study was an evaluation of the feasibility and efficacy of laparoscopic radiofrequency thermal ablation of symptomatic nodular uterine adenomyosis. Methods:Fifteen women with symptomatic nodular adenomyosis, who had no plans for pregnancy but declined hysterectomy, underwent radiofrequency thermal ablation. Ultrasonography was performed at baseline and at postoperative follow-ups at 3, 6, 9, and 12 months. The impact of uterine adenomyosis–related symptoms was assessed according to the visual analog scale. Results:The median number of nodular lesions treated per patient was 1 (range, 1–2). The median baseline volume of the adenomyosis area was 60 cm3 (range, 18 –128). The median reduction in volume was 32, 49.4, 59.6, and 65.4% at 3, 6, 9, and 12 months, respectively. A significant progressive improvement in the symptoms score was observed at the 4 follow-ups. Conclusion:In this study, laparoscopic radiofrequency thermal ablation reduced uterine adenomyosis–related symptoms and volume, with significant relief of symptoms.