Radiofrequency thermal ablation of submucosal leiomyoma: A preliminary report on health, symptom, and quality of life outcomes

Objectives: Submucosal leiomyoma commonly causes abnormal uterine bleeding, menstrual abnormalities, and infertility, and is usually treated by hysteroscopy. However, not all submucosal leiomyomas can be treated by hysteroscopy; patients with high-scoring submucosal leiomyoma must undergo transabdominal myomectomy to preserve the uterus. This article reports experience with a group of patients who underwent transvaginal radiofrequency (RF) thermal ablation of uterine submucosal leiomyomas of all grades, with emphasis on the safety and efficacy of this procedure. Study design: This was a prospective observational study. Materials and methods: Premenopausal women with symptomatic uterine submucosal leiomyoma were included in this study. The pre- and postoperative myoma volumes were measured by three-dimensional ultrasonography. The effect of symptoms on health-related quality of life (HRQoL) was assessed using the Uterine Fibroids Symptom and Quality of Life questionnaire. Results: Submucosal leiomyoma volume reduction rate was 75.5 ± 14.1% at 3 months and 80.7 ± 22.1% at 6 months postoperation. No differences were seen in the volume reduction rate according to the preoperative grade of leiomyoma. Symptom scores and HRQoL scores showed improvements 18 months after surgery with no differences between grades. Penetration/burn injuries of the bowel or bladder, sepsis, shock, embolism, and peritonitis were not reported. Conclusions: Transvaginal RF thermal ablation is a good treatment method for symptomatic submucosal leiomyoma, especially for patients with a high leiomyoma grade and when there is no choice for treatment except hysterectomy or hysterotomy.