Tailored Radiofrequency Ablation of Uterine Myomas
Study Details
Study Description
Brief Summary
To perform the use of radiofrequency myolysis (RFM) for the treatment of intra-uterine fibroids through less invasive access by combining trans-vaginal ultrasound, hysteroscopy and laparoscopy
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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N/A |
Detailed Description
Given that the RF ablation of solid tumors of the liver and other organs is successfully used as a usual approach, the investigators have decided to transfer this technology to an original treatment of uterine fibroids. The access to each individual fibroid was determined considering passage of the needle towards its centre through only compromised tissue and by the shortest possible route by combining trans-vaginal ultrasound, hysteroscopy and laparoscopy. To optimize radiofrequency myolysis, in fact, the investigators decided to improve the procedure by inserting three innovative elements: application of a virtual needle tracking system to follow the RF electrode during the ablation session, real-time monitoring of RF ablation by contrast-enhanced ultrasound and systematic biopsy of the lesions before electro-coagulation.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Radiofrequency myolysis of uterine fibroids 54 premenopausal participants with symptomatic uterine myomas |
Device: RADIOFREQUENCY ABLATION OF UTERINE MYOMAS
The ablation device consisted of an radiofrequency (RF) energy generator (STARmed, RF generator VRS01) and an electric pump for the continuous cooling of the electrode tip. The RF generator to which the electrode (STARmed Gyeonggi-Do, Korea) is connected displays simultaneously the temperature of the electrode tip, the tissue impedance characteristics, the power and the ablation time. A 35 cm long 18Gauge internally cooled electrode with an exposed tip of 10 mm or a variable exposed tip was used
Other Names:
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Outcome Measures
Primary Outcome Measures
- Myoma volumes after radiofrequency myolysis (RFM) [12 months]
The outcomes evaluated after RFM were myoma volumes (cubic centimeters)
- Myoma diameters after radiofrequency myolysis (RFM) [12 months]
The outcomes evaluated after RFM were myoma diameters (centimeters)
- Uterine Fibroid Symptom and Quality of Life (UFS-QOL) score after radiofrequency myolysis (RFM) [12 months]
Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire with scores ranging from 0 to 100, were higher QOL scores mean a better health-related QOL 1 and a 10-point scale used for each reported symptom.
Secondary Outcome Measures
- Surgical time of radiofrequency myolysis (RFM) [12 months]
The surgical time (minutes) for each different type of surgical access
- Surgical time of radiofrequency myolysis (RFM) assisted by new technologies [12 months]
The reduction of surgical time (minutes) with the use of a virtual global positioning system (GPS) track system or a contrast-enhanced ultrasound during the ablation
- Pre-intervention biopsy associated to radiofrequency myolysis (RFM) [12 months]
The number of biopsies for treated fibroma
Eligibility Criteria
Criteria
"Inclusion Criteria":
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women who had symptomatic myomas with diameters ranging between 1.2 and 7.7 cm. - patients who had declined hysterectomy or laparoscopic myomectomy
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submucosal fibroids with intramural extension ≥50%
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intramural fibroids (FIGO G3 / G4 types)
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subserosal fibroids (FIGO G5 / G6 types)
"Exclusion Criteria":
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Women with intracavitary (FIGO G0 / G1 types) or subserosal-pedunculated fibroids / (FIGO G7 types)
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genital malignancy
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cervical dysplasias
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pelvic infection / adhesions
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severe systemic diseases
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pregnancy
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deeply infiltrating endometriosis
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patients who took gonadotropin-releasing hormone therapy or acetate ulipristal within 6 months
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | International Evangelical Hospital | Genoa | Italy | 16125 |
Sponsors and Collaborators
- International Evangelical Hospital
Investigators
- Principal Investigator: Alessandro FASCIANI, International Evangelical Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- Lin L, Ma H, Wang J, Guan H, Yang M, Tong X, Zou Y. Quality of Life, Adverse Events, and Reintervention Outcomes after Laparoscopic Radiofrequency Ablation for Symptomatic Uterine Fibroids: A Meta-Analysis. J Minim Invasive Gynecol. 2019 Mar - Apr;26(3):409-416. doi: 10.1016/j.jmig.2018.09.772. Epub 2018 Sep 22. Review.
- Stewart EA, Lytle BL, Thomas L, Wegienka GR, Jacoby V, Diamond MP, Nicholson WK, Anchan RM, Venable S, Wallace K, Marsh EE, Maxwell GL, Borah BJ, Catherino WH, Myers ER. The Comparing Options for Management: PAtient-centered REsults for Uterine Fibroids (COMPARE-UF) registry: rationale and design. Am J Obstet Gynecol. 2018 Jul;219(1):95.e1-95.e10. doi: 10.1016/j.ajog.2018.05.004. Epub 2018 May 8.
- Toub DB. A New Paradigm for Uterine Fibroid Treatment: Transcervical, Intrauterine Sonography-Guided Radiofrequency Ablation of Uterine Fibroids with the Sonata System. Curr Obstet Gynecol Rep. 2017;6(1):67-73. doi: 10.1007/s13669-017-0194-2. Epub 2017 Feb 15. Review.
- Yin G, Chen M, Yang S, Li J, Zhu T, Zhao X. Treatment of uterine myomas by radiofrequency thermal ablation: a 10-year retrospective cohort study. Reprod Sci. 2015 May;22(5):609-14. doi: 10.1177/1933719114556481. Epub 2014 Oct 29.
- 295/2018