• Victoria E Rey, Rocío Labrador, María Falcon, and José Luis Garcia-Benitez.
• CAREMUJER Clinic, Sevilla, Spain.
• J Laparoendosc Adv Surg Tech A. 2019 Jan 1; 29 (1): 24-28.

ObjectivesThe aim was to study technique, complications, and outcomes of transvaginal ultrasound-guided radiofrequency myolysis (TRFAM) of uterine myomas.Materials And MethodsA prospective observational study of 205 patients with metrorrhagia secondary to type II/III submucosal or intramural cavity-distorting myomas undergoing outpatient TRFAM under sedation between September 2015 and February 2017.Main Outcome MeasuresIntraoperative and postoperative complications, correction of metrorrhagia, patient satisfaction, mean volume of myoma, and hemoglobin level at 1, 3, 6, and 12 months after the procedure.ResultsThe mean age of the patients was 38.7 years (range 26-49). The mean operating time was 17 minutes (range 11-44). The mean postoperative time to discharge home was 2.3 hours (range 1.6-3.2). There were 2 (1.46%) patients with type III-b complications (Clavien-Dindo classification). The mean (standard deviation [SD]) preoperative myoma volume was 122.4 [182.5] cm3. There was a significant reduction in the mean volume at 1 (85.2 [147.9] cm3; P = .001), 3 (67.3 [138.0] cm3; P = .001), 6 (59.3 [135.3] cm3; P = .001), and 12 months (49.6 [121.4] cm3; P = .001). The mean volume reduction at 12 months was 60% when compared with preoperative volume. All patients had normal menstruation at a mean follow-up of 3 months (range 1.5-6).ConclusionTRFAM is an effective and safe technique in selected patients for the treatment of metrorrhagia secondary to myomas.

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