Transcervical radiofrequency ablation of focal adenomyosis: pilot results

Abstract

Objective: Adenomyosis is a common gynecological disease, which occurs in women in reproductive age and is characterized by the presence of endometrial glands and stroma within the myometrium. Abnormal uterine bleeding, pelvic pain as well as infertility can be associated with adenomyosis. There are two main types of adenomyosis: diffuse and focal. Previously, adenomyosis was diagnosed only upon histopathological examination after hysterectomy and/or adenomyomectomy. However, the development of imagining techniques such as transvaginal ultrasound and magnetic resonance imaging enables the diagnosis of adenomyosis (diffuse and focal) without any surgical intervention. When medical therapy is contraindicated or ineffective, or if patients have a fertility desire, a surgical treatment may be necessary.

Methods: In this study, a total of 13 patients with 16 areas of focal adenomyosis were treated. All patients provided their informed consent to undergo transcervical adenomyosis ablation treatment with the Sonata System, aware that the safety and effectiveness of transcervical radiofrequency (RF) ablation for the treatment of adenomyosis has not been established. Follow-up was performed six months after Sonata treatment.

Results: The positive results relating to the improvement of symptoms and reduction of adenomyosis lesion size were observed in our study.

Conclusion: Transcervical RF ablation with the Sonata System may be a promising therapeutic alternative method to conventional procedures such as hysterectomy for the treatment of focal adenomyosis, disease which has limited therapeutic approach, and may enable a minimally invasive, uterine preserving option.

Keywords:

• Focal adenomyosis
• radiofrequency ablation
• Sonata System
• transcervical radiofrequency adenomyosis ablation
• transcervical radiofrequency fibroid ablation

Author contributions

EP: manuscript writing, data management and data analysis. SS and TR: project development and administration.

Ethical approval

This retrospective protocol was approved by the Ethics Committee of North Rhine Westphalia (protocol number 107/2023). The requirement for informed consent was waived because of the retrospective nature of the study. All patient data were anonymized for the purposes of reporting.

Disclosure statement

EP has no conflict of interest. SS and TR are consultants for the Sonata System. The authors report no other conflicts of interest in this work.

Additional information

Funding

This study was not funded.