Objective: To assess the feasibility of percutaneous microwave ablation in the treatment of diffuse adenomyosis.
Methods: With a mean age of 39.2 years old, 16 patients with symptomatic adenomyosis underwent percutaneous microwave ablation (PMA). The symptoms included severe dysmenorrheal and anemia. The definite diagnosis was made by magnetic resonance (MR) imaging. Two microwave therapeutic antennas were inserted into the myometrium with adenomyosis. The microwave emission was seized when the ablated zone was over half of the total lesion. The complications, side effects and early therapeutic effects were observed during the period of treatment and at 3 and 6 months post-treatment.
Results: The average ablation duration was 700 s. The average ablated area was 72% (range: 60% - 80%). None of the patients developed complications during and after ablation. Fifteen patients had normal menstrual onset during the month of receiving ablation and one case at Day 30. The amount of menstrual bleeding was less than that before treatment. Dysmenorrhea disappeared after treatment in 13 cases, relieved markedly in 2 and no improvement in 1. The endometrial ectopic growth was not observed after treatment.
Conclusion: The early clinical efficacy of PMA under ultrasound guidance is definite in the treatment of adenomyosis. The symptoms may be eliminated or effectively relieved after treatment. Easy to perform, minimal invasive and safe, the procedure of PMA is an effective therapeutic modality for adenomyosis with the preservation of uterus.