title: Efficacy of multiple microwave endometrial ablation technique for menorrhagia resulting from adenomyosis.
abstract: OBJECTIVE
  Conventional microwave endometrial ablation (MEA) can be insufficient to control menorrhagia resulting from adenomyosis. We compared the standard single ablation technique with multiple MEA - repeating ablation three times in the same region - in patients with adenomyosis and menorrhagia.
  
  
  METHODS
  We performed single MEA in 18 patients and multiple MEA in seven patients between 2007 and 2013. We compared the efficacy of single and multiple MEA using a visual analog scale (VAS) for menorrhagia, dysmenorrhea, and patient satisfaction. We also evaluated the incidence of menorrhagia recurrence, amenorrhea, and procedure complications in relation to patients' clinical factors.
  
  
  RESULTS
  VAS scores for improved menorrhagia and patient satisfaction were significantly higher in the multiple MEA group than in the single MEA group; however, the operative time was longer in the multiple-treatment group. There were no statistical differences between groups in hemoglobin levels, VAS improvement for dysmenorrhea, menorrhagia recurrence, frequency of complications, or amenorrhea rate.
  
  
  CONCLUSIONS
  Multiple MEA successfully controls menorrhagia from adenomyosis and achieves a higher satisfaction rate than single MEA.
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine.
authors.forename: Kohei
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakayama
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine.
authors.forename: Masako
authors.initials: M
authors.lastname: Ishikawa
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Katagiri
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Katagiri
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine.
authors.forename: Tomoka
authors.initials: T
authors.lastname: Ishibashi
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine.
authors.forename: Emi
authors.initials: E
authors.lastname: Sato
authors.affiliation: Asakawa Maternity Hospital, Yokohama, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Asakawa
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine.
authors.forename: Satoru
authors.initials: S
authors.lastname: Kyo
mesh_terms: D062788:Adenomyosis / Q000150:complications*; D000328:Adult; D055356:Endometrial Ablation Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008595:Menorrhagia / Q000209:etiology / Q000601:surgery*; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D017060:Patient Satisfaction; D016896:Treatment Outcome
keywords: adenomyosis; dysmenorrhea; menorrhagia; microwave endometrial ablation; visual analog scale