Objectives: The aim was to study technique, complications, and outcomes of transvaginal ultrasound-guided radiofrequency myolysis (TRFAM) of uterine myomas.
Materials and methods: A prospective observational study of 205 patients with metrorrhagia secondary to type II/III submucosal or intramural cavity-distorting myomas undergoing outpatient TRFAM under sedation between September 2015 and February 2017.
Main outcome measures: Intraoperative and postoperative complications, correction of metrorrhagia, patient satisfaction, mean volume of myoma, and hemoglobin level at 1, 3, 6, and 12 months after the procedure.
Results: The mean age of the patients was 38.7 years (range 26-49). The mean operating time was 17 minutes (range 11-44). The mean postoperative time to discharge home was 2.3 hours (range 1.6-3.2). There were 2 (1.46%) patients with type III-b complications (Clavien-Dindo classification). The mean (standard deviation [SD]) preoperative myoma volume was 122.4 [182.5] cm3. There was a significant reduction in the mean volume at 1 (85.2 [147.9] cm3; P = .001), 3 (67.3 [138.0] cm3; P = .001), 6 (59.3 [135.3] cm3; P = .001), and 12 months (49.6 [121.4] cm3; P = .001). The mean volume reduction at 12 months was 60% when compared with preoperative volume. All patients had normal menstruation at a mean follow-up of 3 months (range 1.5-6).
Conclusion: TRFAM is an effective and safe technique in selected patients for the treatment of metrorrhagia secondary to myomas.
Keywords: minimal invasive surgery; myolysis; radiofrequency ablation; transvaginal approach; uterine myoma.