Ultrasound-guided transcervical radiofrequency ablation for symptomatic uterine adenomyosis

Br J Radiol. 2017 Jan;90(1069):20160119. doi: 10.1259/bjr.20160119. Epub 2016 Oct 28.

Abstract

Objective: To retrospectively evaluate the midterm outcomes of transvaginal ultrasound-guided radiofrequency ablation (RFA) for the treatment of symptomatic uterine adenomyosis.

Methods: 87 patients with symptomatic uterine adenomyosis, who met the inclusion criteria, were enrolled in our study from January 2013 to October 2015. All of the patients underwent transvaginal ultrasound-guided RFA and were followed up for 12 months. Assessment end points included uterus volume reduction rate, lesion regression rate, dysmenorrhoeal score, symptom severity score (SSS) and adverse events.

Results: In all 87 patients, 81 patients fulfilled the follow-up evaluations post-ablation. The mean uterine volume reduction rate was 35.8% at 1 month, 40.8% at 6 months and 41.2% at 12 months post-ablation. Dysmenorrhoea and SSS statistically significantly declined. Reintervention rate was 18.5%. Two patients developed intrauterine adhesion after ablation. No serious complications including penetration or burn injuries of the nearby organs were observed.

Conclusion: Ultrasound-guided RFA might be a safe and effective minimally invasive alternative in the treatment of symptomatic adenomyosis. Advances in knowledge: This is the first study to evaluate the efficacy and safety of ultrasound-guided RFA for the treatment of adenomyosis to our knowledge. This is also the first study to provide various changes of intrauterine cavity after this treatment.

Publication types

  • Evaluation Study

MeSH terms

  • Adenomyosis / pathology
  • Adenomyosis / surgery*
  • Adult
  • Catheter Ablation / adverse effects
  • Catheter Ablation / methods
  • China
  • Cohort Studies
  • Dysmenorrhea / diagnosis
  • Dysmenorrhea / etiology
  • Female
  • Follow-Up Studies
  • High-Intensity Focused Ultrasound Ablation / adverse effects
  • High-Intensity Focused Ultrasound Ablation / methods*
  • Humans
  • Middle Aged
  • Myometrium / pathology
  • Myometrium / surgery*
  • Patient Safety*
  • Patient Selection
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome