Effectiveness of microwave endometrial ablation combined with hysteroscopic transcervical resection in treating submucous uterine myomas  

作　　者：Toshiyuki Kakinuma Kaoru Kakinuma Ayano Shimizu Ayaka Kaneko Masataka Kagimoto Takafumi Okusa Eri Suizu Koyomi Saito Yoshio Matsuda Kaoru Yanagida Nobuhiro Takeshima Michitaka Ohwada 

机构地区：[1]Department of Obstetrics and Gynecology,International University of Health and Welfare Hospital,Nasushiobara 329-2763,Japan

出　　处：《World Journal of Clinical Cases》2022年第36期13200-13207,共8页世界临床病例杂志

摘　　要：BACKGROUND Hypermenorrhea is characterized by excessive menstrual bleeding that causes severe anemia and interferes with everyday life.This condition can restrict women’s social activities and decrease their quality of life.Microwave endometrial ablation(MEA)using a 2.45-GHz energy source is a minimally invasive alternative to conventional hysterectomy for treating hypermenorrhea that is resistant to conservative treatment,triggered by systemic disease or medications,or caused by uterine myomas and fibrosis.The popularity of MEA has increased worldwide.Although MEA can safely and effectively treat submucous myomas,some patients may still experience recurrent hypermenorrhea postoperatively and may require additional treatment.AIM To investigate the efficacy of MEA combined with transcervical resection(TCR).METHODS Participants underwent cervical and endometrial evaluations.Magnetic resonance imaging and hysteroscopy were performed to evaluate the size and location of the myomas.TCR was performed before MEA using a hystero-resectoscope.MEA was performed using transabdominal ultrasound.The variables included operation time,number of ablation cycles,length of hospital stay,and visual analog scale cores for hypermenorrhea,dysmenorrhea,and treatment satisfaction at 3 and 6 mo postoperatively.The postoperative incidence of amenorrhea,changes in hemoglobin concentrations,and MEA-related complications were evaluated.RESULTS A total of 34 women underwent a combination of MEA and TCR during the study period.Two patients were excluded from the study as their histopathological tests identified uterine malignancies(uterine sarcoma and endometrial cancer).The 32 eligible women(6 nulliparous,26 multiparous)had a mean age of 45.2±4.3 years(range:36–52 years).Patients reported very severe hypermenorrhea(10/10 points on the visual analog scale)before the procedure.However,after the procedure,the hypermenorrhea scores decreased to 1.2±1.3 and 0.9±1.3 at 3 and 6 mo,respectively(P<0.001).The mean follow-up duration was 33.8±16

关 键 词：DYSMENORRHEA Endometrial ablation techniques MENORRHAGIA Microwaves MYOMA UTERUS 

分 类 号：R737.33[医药卫生—肿瘤]