[Laparoscopic ultrasound-guided radiofrequency ablation of uterine fibroid : a retrospective study].

Objective : To assess clinical and radiological efficacy and safety of laparoscopic ultrasound-guided radiofrequency ablation of uterine leiomyomas. Material and Methods : Thirty-three patients with symptomatic uterine leiomyomas FIGO type 2 to 7, have undergone a laparoscopic ultrasound-guided radiofrequency ablation at Croix Rousse university hospital center (Hospices Civils de Lyon) and at Saint-Vincent de Paul hospital in Lille, between june 2020 and december 2022. The characteristics of each myoma and the symptoms were assessed with pelvic MRI and with Higham score, SSS and HRQL scores preoperatively and at 6 months. Results : A total of 54 fibroids have been treated in 33 patients. We observed a significant decrease of the volume 6 months after the surgery, on average 21ml (55,97 ml vs 74,37 ml, 95%CI [7,13 - 34,88], p=0.001). The maximum diameter of each fibroid was also significantly reduced on average 11,78mm (41,89 vs 52,06, IC 95% [8,83 - 14,73], p<0,05). We noticed a significant decrease of the NRS for dysmenorrhea on average 2.79 points (2,1 vs 4,89, 95%CI [1,14-4,42], p<0,05). There was also a trend to improvement of menorrhagia, assess by Higham score. Indeed, 70,8% of the patients had menorrhagia. Menorrhagia was improved of 108,3 points with an average Higham score before surgery of 197,3versus 87,9 after surgery (IC 95% [47,9-168,8], p=0,001). Concerning UFS-QOL score: the symptom severity score (SSS) decreased on average 33 points, testifying of symptom improvement (27,04 vs 60,89, 95%CI [22,92 - 43,39], p<0,001) and the HRQL score increased on average 20 points testifying quality of life improvement (65,57 vs 42,7, 95%CI [15,83-37,85], p<0,001). No severe adverse event has been reported. Conclusion : In this first French study about radiofrequency ablation, we confirm its efficiency for improvement of symptoms and quality of life, but other study are mandatory to confirm the safety of this procedure in particular in patients with a wish to conceive.