Laparoscopic multi-bipolar radiofrequency ablation of fibroids: impact on quality of life

Résumé fourni par la source

OBJECTIVE: To evaluate the effectiveness of multi-bipolar radiofrequency ablation compared to standard laparoscopic myomectomy in treating uterine fibroids, focusing on women's quality of life. DESIGN: Retrospective observational cohort study. SETTING: La Conception Hospital, APHM-Marseille, France. PATIENTS: 50 women with symptomatic fibroids treated between December 2021 and December 2023. INTERVENTION: Laparoscopic radiofrequency ablation or conventional laparoscopic myomectomy. MEASUREMENTS AND MAIN RESULTS: After excluding patients who did not complete the preoperative quality-of-life questionnaire, 34 underwent myomectomy and 16 radiofrequency ablation. At 3 months, no significant differences were observed in HRQOL improvement (9.2 ± 34.3 vs 24.2 ± 28.2, p = 0.14), SSS (- 27.5 ± 31.5 vs - 23.3 ± 33, p = 0.66), or FSFI (0.9 ± 14.7 vs - 1.5 ± 10.8, p = 0.40). The 6-month outcomes also showed no significant difference. Baseline fibroid-specific quality of life was significantly and negatively associated with improvement (p < 0.05). CONCLUSION: Both procedures improved quality of life and reduced fibroid-related symptoms at 3 and 6 months, with no significant difference. Myolysis showed fewer peri- and postoperative complications, suggesting a better safety profile and potential as a conservative treatment option. TRIAL REGISTRATION: The ethics committee of Aix Marseille University approved this study on April 18, 2024, under the reference number 2024-04-18-08.

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