Conservative treatment for fibroids in the uterus: Radiofrequency (RF) Myolysis

Uterine fibroids, also known as leiomyomas, are non-cancerous growths that develop in the uterus. They are common, particularly in women of reproductive age, and can lead to symptoms such as heavy menstrual bleeding, pelvic pain and reproductive issues. While traditional treatments for fibroids include surgical options like hysterectomy and myomectomy, there is a growing interest in conservative, less invasive approaches. One such method is radiofrequency (RF) myolysis, a technique that utilises energy to reduce the size and symptoms of fibroids.

What is RF Myolysis?

Radiofrequency myolysis is a minimally invasive procedure that uses thermal energy to ablate, or destroy, fibroid tissue. The process involves inserting a needle-like probe into the fibroid under ultrasound guidance. Once in place, the probe emits RF energy, generating heat that causes the fibroid cells to die and shrink over time. This technique can be performed via laparoscopy, transvaginally, or through the cervix, depending on the location and size of the fibroids.

Benefits of RF Myolysis

1. *Minimally Invasive*: Compared to traditional surgical methods, RF myolysis is less invasive, often requiring only small incisions or no incisions at all. This results in reduced recovery time and lower risk of complications.
2. *Preservation of the Uterus*: For women who wish to retain their uterus, whether for personal or reproductive reasons, RF myolysis offers an effective alternative to hysterectomy.
3. *Symptom Relief*: Clinical studies have shown that RF myolysis can significantly reduce symptoms associated with fibroids, such as heavy menstrual bleeding and pelvic pain.
4. *Outpatient Procedure*: The procedure is typically performed on an outpatient basis, allowing patients to return home the same day.

The Procedure

Before the procedure, patients undergo imaging studies, such as ultrasound or MRI, to map the size and location of the fibroids. During the procedure:

1. *Anaesthesia*: The patient is given local or general anaesthesia, depending on the approach used.
2. *Guidance*: The physician uses ultrasound or laparoscopic guidance to accurately position the RF probe into the fibroid.
3. *Ablation*: Once in place, the RF energy is delivered to the fibroid, causing controlled thermal damage. This process usually takes a few minutes per fibroid.
4. *Recovery*: After the procedure, patients are monitored for a short period before being discharged. Most can resume normal activities within a few days.

Outcomes and Efficacy

Research indicates that RF myolysis is effective in reducing fibroid size and alleviating symptoms. Studies report high patient satisfaction rates, with many experiencing significant improvement in menstrual bleeding and pelvic discomfort. Additionally, the procedure has shown promising results in preserving fertility, with some women successfully conceiving post-treatment.

Considerations and Risks

While RF myolysis is generally safe, it is not without risks. Potential complications include infection, bleeding and injury to surrounding tissues. It is also important to note that not all fibroids are suitable for RF myolysis. The size, number and location of fibroids, as well as the patient's overall health and reproductive plans, must be carefully considered.