Combined Laparoscopic Radiofrequency Ablation and Laparoscopic Myomectomy: An Analysis of the ULTRA-Registry.

Abstract

Background and objectives: Uterine fibroids are common in women and can lead to symptoms of abnormal uterine bleeding, pelvic pain and bulk symptoms. Treatment can be medical or surgical. This study aims to describe characteristics and outcomes of women undergoing combined laparoscopic radiofrequency ablation (lap-RFA) and laparoscopic myomectomy (lap-MYO) to treat symptomatic uterine fibroids.

Methods: This is a multicenter prospective cohort study including both academic centers and private practices. Women in the Uterine Leiomyoma Treatment by Radiofrequency Ablation (ULTRA) Study who were scheduled to undergo surgical management of fibroids underwent a combined lap-RFA and lap-MYO. We assessed quality of life and sexual function changes from before to 12 months after surgery using validated questionnaires.

Results: Of the 480 participants in ULTRA, 49 underwent a combined lap-RFA and lap-MYO procedure between 2014 and 2022. The mean number of fibroids treated was 3.6 (standard deviation [SD] 2.0). The mean number of days to return to usual activities was 12.7 (SD 10.1). The Uterine Fibroid Symptom and Health-Related Quality of Life Questionnaire symptom severity score (0-100 points) improved by 36.4 points (SD 27.0, P < .001) at 12 months and the Sexual Health Outcomes in Women Questionnaire (0-100 points) assessment of pelvic problems interference with sex improved by 13 points (SD 34.4 P = .02) as early as 6 weeks. About 75% of women were satisfied with the surgery at 12 months.

Conclusion: Combining lap-RFA and lap-MYO is associated with few peri-operative events, satisfactory recovery time, and significant improvement in quality-of-life measures with high patient satisfaction through 12 months after surgery.