Outpatient multimodality management of large submucosal myomas using transvaginal radiofrequency myolysis.

STUDY

OBJECTIVE

To evaluate the safety and efficacy of transvaginal radiofrequency myolysis (RFM) with or without combined hysteroscopy for treatment of large submucosal leiomyomas with a substantial intramural portion.

DESIGN

Retrospective observational study (Canadian Task Force classification III).

SETTING

Hospital outpatient department.

PATIENTS: Twenty-four patients with large submucosal leiomyomas with a substantial intramural portion.

INTERVENTIONS: Transvaginal RFM with or without combined hysteroscopy.

MEASUREMENTS AND MAIN

RESULTS

Twenty-four patients with large submucosal leiomyomas with a substantial intramural portion were enrolled to undergo stepwise RFM. Additional hysteroscopic myomectomy was performed in 6 patients at 3 to 6 months after RFM. Myoma volumes were measured via 3-dimensional ultrasonography before RFM and at 1, 3, 6, 12, and 24 months postoperatively. Symptom severity was assessed using the Uterine Fibroid Symptom and Quality of Life questionnaire and the Health-Related Quality of Life questionnaire. The total volume reduction rate 24 months postoperatively was 84.2%. Symptom severity and health-related quality of life scores demonstrated substantial improvements at 12 months after RFM.

CONCLUSIONS

RFM with or without hysteroscopy is an effective treatment for large myomas with deep intramural positioning, and it seems safe for use in all patients with submucosal myoma-related symptoms.