Transvaginal Ultrasound and Laparoscopy-guided Microwave Ablation for Uterine Myoma and Adenomyosis: Preliminary Results.

Abstract

Objectives: The objective of the study was to evaluate the effectiveness of microwave ablation (MWA) in treating uterine myoma and adenomyosis.

Materials and methods: Twenty premenopausal women aged 30-45 years, diagnosed with symptomatic uterine fibroids (n = 13) or adenomyosis (n = 7), were prospectively enrolled between November 2021 and March 2022 at Kaohsiung Medical University Hospital. All participants underwent percutaneous MWA under combined transvaginal ultrasound and laparoscopic guidance using a 13-gauge antenna and the Emprint™ Ablation Generator with Thermosphere™ technology. Contrast-enhanced MRI was used to assess lesion volume at baseline and 3 months postprocedure. Symptom severity and quality of life (QOL) were evaluated using the Visual Analogue Scale (VAS) for pain, Pictorial Blood Assessment Chart (PBAC) for menstrual bleeding, and the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire at baseline and at 1, 3, and 6 months posttreatment.

Results: Follow-up showed significant reductions in pain, bleeding, and symptom severity. VAS, PBAC, and UFS-QOL scores all improved significantly. Myoma volume decreased by 33.4%, whereas adenomyosis showed meaningful symptom improvement despite nonsignificant volume change. No major complications occurred.

Conclusion: Transvaginal ultrasound- and laparoscopy-guided MWA is a safe, effective, and minimally invasive treatment for uterine fibroids and adenomyosis, providing rapid symptom relief and improved QOL with uterine preservation.