| ObjectiveTo assess the clinical efficacy of ultrasound-guided transabdominal radiofrequency ablation(RFA)on uterine fibroids and adenomyosis.Participants and MethodsA total of 73 cases of uterine leiomyoma with 88 fibroids and 23 cases of adenomyosis diagnosed by clinical and ultrasonographic examination in The 900th Hospital of Joint Logistic Support Force,PLA From March 2017 to September2018 were included in this study.The effect of intraoperative ablation was evaluated by the ablation rate of uterine fibroid.The changes of uterine fibroid or uterine volume were compared in 1,3,6 and 12 months after RFA,and the hemoglobin level in anemia patients was tested 3 months after operation.Six months after RFA,the Uterine Fibroid Symptom and Quality of Life(UFS-QOL)questionnaire and dysmenorrhea scoring were investigated to evaluate the efficacy of clinical treatment in the patients with adenomyosis.The adverse reactions and complications during follow-up period were observed and recorded.Results1.RFA for uterine fibroids:There were 73 patients(88 fibroids)in this group.The average age of the patients was(44.1±4.6)years ranging from 26 to 55 years.The average diameter of the myomas was 15.7-87.4 mm(mean,46.5±14.3 mm).The average ablation rate of fibroids was 92.8%.The average fibroid reduction rates were 33.9%,52.2%,61.2%and 64.7%at 1,3,6 and 12 months after RFA,respectively.During the follow-up,the volume of uterine fibroid and the hemoglobin quantification were re-examined in the anemia patients.The scores of SSS and HR-QOL were significantly improved compared with those before treatment.All patients successfully completed the ablation process,whereas 52.1%of the patients had different types of untoward effects.The main untoward effects were vaginal bleeding,vaginal secretion,lower abdominal pain and menorrhagia.Most of these adverse reactions were relieved without special treatment.After radiofrequency ablation,fleshy tissue discharged from the vagina occurred in two cases of submucosal leiomyoma,in which one was febrile and was improved after the anti-inflammatory treatment and excretion of fibroid tissue.2.RFA for adenomyosis:There were 23 patients in this group.The average age of the patients was(40.8±5.8)years and the age ranged between 28 and 49 years.The depth of uterine wall was 38.2 to 70.4 mm(mean,51.3±8.6 mm).The average uterine volume was(276.2±91.8)cm~3.The average reduction rates of uterine volume were 19.5%,28.9%,38.6%and 37.0%at 1,3,6 and 12 months after RFA,respectively.During the follow-up,the uterine volume,the hemoglobin quantification of anemia patients and clinical symptoms were significantly improved compared with those before treatment in the patients.All patients successfully completed the ablation process with different types of untoward effects occurring in 52.2%of the patients.The main adverse reactions were vaginal secretion,vaginal bleeding and menstrual disorder.Most of these adverse reactions were relieved or vanished without special treatment.ConclusionRadiofrequency ablation for uterine fibroid and adenomyosis exhibited a definite curative effect.After RFA treatment,the volume of uterine or uterus fibroid was significantly decreased,menorrhagia,dysmenorrhea,anemia and other related symptoms were improved obviously,and the quality of life of patients was improved.Radiofrequency ablation for uterine fibroid and adenomyosis is a minimally invasive technique that can retain the uterus with minor complications and adverse reactions and the absence of serious complications after RFA treatment.RFA therapy can be used as one of the minimally invasive treatments for uterine fibroids and adenomyosis to benefit more patients. |
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