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Outpatient multimodality management of large submucosal myomas using transvaginal radiofrequency myolysis
Hyun Hee Cho1, Mee Ran Kim1, Jang Heub Kim1
1Department of Obstetrics and Gynecology, Catholic University Medical College, Seoul, Korea.
Study Objective:
To evaluate the safety and efficacy of transvaginal radiofrequency myolysis (RFM) with or without combined hysteroscopy for treatment of large submucosal leiomyomas with a substantial intramural portion.
Design:
Retrospective observational study (Canadian Task Force classification III).
Setting:
Hospital outpatient department.
Patients:
Twenty-four patients with large submucosal leiomyomas with a substantial intramural portion.
Interventions:
Transvaginal RFM with or without combined hysteroscopy.
Measurements And Main Results:
Twenty-four patients with large submucosal leiomyomas with a substantial intramural portion were enrolled to undergo stepwise RFM. Additional hysteroscopic myomectomy was performed in 6 patients at 3 to 6 months after RFM. Myoma volumes were measured via 3-dimensional ultrasonography before RFM and at 1, 3, 6, 12, and 24 months postoperatively. Symptom severity was assessed using the Uterine Fibroid Symptom and Quality of Life questionnaire and the Health-Related Quality of Life questionnaire. The total volume reduction rate 24 months postoperatively was 84.2%. Symptom severity and health-related quality of life scores demonstrated substantial improvements at 12 months after RFM.
Conclusions:
RFM with or without hysteroscopy is an effective treatment for large myomas with deep intramural positioning, and it seems safe for use in all patients with submucosal myoma-related symptoms.
