Gynecologie, obstetrique, fertilite & senologie · 2026
[Uterine fibroid myolysis: Outcomes and quality of life].
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Lafourcade Julie, Lucot Jean-Philippe, Declas Estelle, Chaldaureille Cassandra, Detchev Romain
Аннотация
OBJECTIVE: Uterine fibroids are a common benign condition that causes pelvic symptoms and impairs quality of life. Myolysis, a minimally invasive technique for thermal destruction of fibroids, is a conservative alternative.
MATERIALS AND METHODS: Retrospective single-center study including 49 patients operated on at Saint-Vincent de Paul Hospital (Lille) between August 2021 and December 2024 for symptomatic fibroids (FIGO 2 to 6). Patients were treated with laparoscopic or vaginal myolysis under ultrasound guidance. The primary endpoint was the reduction in fibroid volume on MRI at 6months. Secondary endpoints included changes in VAS, HIGHAM, UFS-QOL (HRQL, SSS) scores.
RESULTS: A total of 93 fibroids were treated. The median reduction in fibroid volume was significant: -15cm3 [-29.3; -1.4], or -38.78% [-62.14; -6.02] of their volume (P<0.0001). The VAS, HIGHAM, and SSS scores improved significantly, with a concomitant increase in HRQL (+24.46 points, P<0.0001). The overall complication rate was 20.4%, including two major complications (grade 3B). Nine patients (18.4%) required repeat surgery for additional treatment.
CONCLUSION: Radiofrequency myolysis is a promising minimally invasive alternative for uterine fibroids, improving symptoms and quality of life, but prospective studies are needed to confirm its efficacy and safety and standardize its indications.
MATERIALS AND METHODS: Retrospective single-center study including 49 patients operated on at Saint-Vincent de Paul Hospital (Lille) between August 2021 and December 2024 for symptomatic fibroids (FIGO 2 to 6). Patients were treated with laparoscopic or vaginal myolysis under ultrasound guidance. The primary endpoint was the reduction in fibroid volume on MRI at 6months. Secondary endpoints included changes in VAS, HIGHAM, UFS-QOL (HRQL, SSS) scores.
RESULTS: A total of 93 fibroids were treated. The median reduction in fibroid volume was significant: -15cm3 [-29.3; -1.4], or -38.78% [-62.14; -6.02] of their volume (P<0.0001). The VAS, HIGHAM, and SSS scores improved significantly, with a concomitant increase in HRQL (+24.46 points, P<0.0001). The overall complication rate was 20.4%, including two major complications (grade 3B). Nine patients (18.4%) required repeat surgery for additional treatment.
CONCLUSION: Radiofrequency myolysis is a promising minimally invasive alternative for uterine fibroids, improving symptoms and quality of life, but prospective studies are needed to confirm its efficacy and safety and standardize its indications.