Radiofrequency Ablation in Focal Uterine Adenomyoma: Long-Term Follow-up of 160 Cases

Study Objective: To evaluate the long-term results of laparoscopic radiofrequency thermal ablation in the treatment of uterine symptomatic focal adenomyosis. Design: Retrospective analysis of prospectively collected data. From 2017 to 2022, 160 women with symptomatic uterine focal adenomyosis underwent laparoscopically guided radiofrequency thermal ablation. Gynecological examination and ultrasound evaluation were performed at the baseline and at the postoperative follow-up at 3 months, 1, 3, and 5 years. The following parameters were evaluated: dysmenorrhea, menorrhagia, ultrasonographic adenomyoma modifications. A visual analog scale (VAS) was used to assess the impact of adenomyosis-related symptoms. Setting: Two academic institution in Verona and Milan, Italy. Patients: One hundred and 60 women with symptomatic uterine focal adenomyosis eager to preserve the uterus. Interventions: All the subjects underwent the same surgical procedure: laparoscopic radiofrequency thermal ablation of uterine focal adenomyosis. Measurements and Main Results: Gynecological examination and ultrasound evaluation were performed at the baseline and at the postoperative follow-up at 3 months, 1, 3, and 5 years. The following parameters were evaluated: dysmenorrhea, menorrhagia, ultrasonographic adenomyoma modifications. A VAS was used to assess the impact of adenomyosis-related symptoms. All patients reported a reduction in menorrhagia and dysmenorrhea. In addition, serial ultrasonography showed a gradual regression of adenomyoma volume. Conclusions: Laparoscopic radiofrequency thermal ablation of adenomyomas successfully reduced the size of the adenomyoma and alleviated associated symptoms. The absence of side effects and long-term complications makes this technique a valuable alternative to major surgical procedures.