Summary:
- Management of uterine fibroid include medical (hormonal, nonhormonal), surgical (myomectomy and hysterectomy), and nonsurgical.Percutaneous microwave ablation is one of the non-surgical ways to treat fibroid, also uterine artery embolization, image-guided thermal ablation, magnetic resonance guided focused ultrasound surgery (MRgFUS), radiofrequency ablation.
- This article is about the feasibility and safety of PMWA. Technical aspects of the procedure, results, and effectiveness will be analyzed as well. In this procedure, antennas are inserted into the fibroid using ultrasound guidance. The microwave generator located in the front of the ablation electrode emits an electromagnetic waves.
- This is a systematic review that includes articles that only describes percutaneous microwave ablation.Published in 2018. Total of 6 articles with 541 patients and 647 fibroids being treated.
- Results: Article includes a table with all the results of the articles being reviewed. It includes the number of patients and fibroids, type of technology used, number of antennas used (>5cm uses double antennas, <5cm uses single antennas), shrinkage rate, technical success rate etc. 100% technical success is being reported in all studies. Clinical success in terms of improvement of the quality of life or health-related quality of life measured using the uterine fibroids symptoms and quality of life questionnaire reached normal level at 12th month, or a significant improvement in scores after treatment. No major complications are observed after the procedures. Minor complications include: lower abdominal pain, discharge of bloody fluids for no more than 20 days, fragments of necrotic tissues from vagina. But these are normal side effects due to endometrial inflammation and irritation.
- Compared with other thermal ablation techniques, microwave ablations: achieve higher intratumoral temperature and larger ablation zone, Less expensive, Equipment is easier to use, Single insertion can be used for large area of necrosis up to 6 cm in diameter, reduction of injury and adhesion, Feasible and safe
- Limitation: No randomized studies exist to compare treatment. Large, randomized, prospective trials are needed for further investigation.
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