Minimal invasive treatment of uterine myoma: Laparoscopic radiofrequency myolysis

Lee, Jeong Jae; Choi, Jung Bum; Park, Eun Hee; Kim, Mi Kyung; Lee, Im Soon

Abstract

OBJECTIVE
To evaluate the feasibility, efficacy and safety of minimal invasive treatment of uterine myoma with laparoscopic radiofrequency (RF) myolysis.
METHODS
69 patients with symptomatic uterine myomas underwent laparoscopy assisted RF myolysis. The accurate targeting and thermal intensity during the procedure were guided by trans-vaginal ultrasound. The measurement of myoma volume and UFS-QOL (Uterine fibroid symptom-quality of life) were obtained once at preoperative period and four times at postoperative period of one week, 1, 3, 6 months. Wilcoxon signed rank test (SPSS 7.5) was used to compare the volume changes of myoma. A significant level of p<0.05 was considered.
RESULTS
107 fibroids were treated with RF myolysis. The mean duration of RF procedure was 15.2+/-18.5 minutes. Mean preoperative volume of treated fibroids was 75.7 cm3 (range: 8.2-367.7) and the mean volume decrease was 12.1+/-10.2%, 32.3+/-40.2%, 48.3+/-33.6%, 53.5+/-18.1% at one week, 1, 3, 6 months. Fifty eight patients had improved symptom severity with UFS-QOL score: symptom severity score 30.8+/-8.2 (mean+/-S.D.), quality of life score 20.3+/-9.2 after RF myolysis. There were 3 cases of RF heat related complication.
CONCLUSION
Early experience of laparoscopy assisted RF myolysis in the treatment of uterine fibroids shows that the method is safe and effective under the guidance of trans-vaginal sonification.