title: Transvaginal ultrasound-guided radiofrequency myolysis for uterine myomas.
abstract: BACKGROUND
  Myolysis is one of the procedures that is claimed to provide significant improvement in myoma status without hysterectomy. Myolysis procedures have been generally performed via laparoscopy, and there are limited data on transvaginal radiofrequency (RF) myolysis. This study investigated the feasibility, efficacy and safety of transvaginal ultrasound-guided RF myolysis.
  
  
  METHODS
  Transvaginal ultrasound-guided RF myolysis was performed on 69 premenopausal women with symptomatic uterine myomas as an outpatient procedure. Outcomes were assessed 1, 3, 6 and 12 months after RF myolysis. Myoma volumes were measured by ulrasonography. Menorrhagia was evaluated by the number of soaked normal-sized sanitary products used per menstrual period and overall symptoms were evaluated using the symptom severity subscale of the uterine fibroids symptom questionnaire.
  
  
  RESULTS
  Mean (± SD) age of patients was 39.8 ± 6.5 years. Mean baseline volume of the dominant myomas was 304.6 ± 229.1 cm(3) and its volume at 3 months following RF myolysis decreased compared with the previous examination (P = 0.002). An improvement of menorrhagia occurred 1, 3, 6 and 12 months after operation (all P < 0.001 versus baseline). Overall symptoms at 1, 3, 6 and 12 months after RF myolysis also improved (all P < 0.001 versus baseline). No major complications were observed or reported. After 12 months, three patients had successfully conceived and delivered and there were no complications during labor or delivery.
  
  
  CONCLUSIONS
  Transvaginal ultrasound-guided RF myolysis might be a safe, effective and minimally invasive outpatient procedure for uterine myoma in terms of size reduction, symptom improvement and safety.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, 388-1 Poognap-dong, Songpa-gu, Seoul 138-736, South Korea. chnkim@amc.seoul.kr
authors.forename: Chung-Hoon
authors.initials: CH
authors.lastname: Kim
authors.forename: So-Ra
authors.initials: SR
authors.lastname: Kim
authors.forename: Hyang-Ah
authors.initials: HA
authors.lastname: Lee
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Hee-Dong
authors.initials: HD
authors.lastname: Chae
authors.forename: Byung-Moon
authors.initials: BM
authors.lastname: Kang
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects*; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008595:Menorrhagia; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011846:Radio Waves / Q000009:adverse effects; D000078702:Radiofrequency Therapy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D047368:Tumor Burden; D018084:Ultrasonography, Interventional / Q000009:adverse effects; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*