title: Outpatient multimodality management of large submucosal myomas using transvaginal radiofrequency myolysis.
abstract: 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.
  
  
  METHODS
  Retrospective observational study (Canadian Task Force classification III).
  
  
  METHODS
  Hospital outpatient department.
  
  
  METHODS
  Twenty-four patients with large submucosal leiomyomas with a substantial intramural portion.
  
  
  METHODS
  Transvaginal RFM with or without combined hysteroscopy.
  
  
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University Medical College, Seoul, Korea.
authors.forename: Hyun Hee
authors.initials: HH
authors.lastname: Cho
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University Medical College, Seoul, Korea. Electronic address: mrkim@catholic.ac.kr.
authors.forename: Mee Ran
authors.initials: MR
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University Medical College, Seoul, Korea.
authors.forename: Jang Heub
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D017115:Catheter Ablation / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D011247:Pregnancy; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000601:surgery*; D014621:Vagina / Q000601:surgery
keywords: Hysteroscopy; Radiofrequency myolysis; Submucosal myoma