Transcervical Interstitial Microwave Ablation Therapy for the Treatment of Adenomyosis: A Novel Alternative to Hysterectomy

Objectives: To investigate the clinical effects of transcervical interstitial microwave irradiation of adenomyotic tissues as an alternative to hysterectomy. Methods: Thirty-three patients who were candidates for hysterectomy for the treatment of adenomyosis associated with menorrhagia were treated by interstitial microwave irradiation using a specifically developed transabdominal ultrasound probe attachment for transcervical puncture along with microwave endometrial ablation, as an alternative to hysterectomy. Primary outcomes were changes in the venous hemoglobin level and the volume of the uterine body before and after treatment. Secondary outcomes were the visual-analogue scale (VAS) score for menorrhagia and dysmenorrhea after treatment. Results: At 3 months after surgery, the average hemoglobin level significantly increased by 4.6 g/dL. The volume of the uterine body significantly decreased to 53% and 52% of the volume before treatment at 3 and 12 months, respectively. VAS scores indicated an improvement in menorrhagia and dysmenorrhea. Conclusions: Transcervical interstitial microwave ablation therapy combined with microwave endometrial ablation reduced the uterine body volume and relieved menorrhagia and dysmenorrheal caused by adenomyosis. This strategy is a promising alternative to hysterectomy for the treatment of symptomatic adenomyosis.