Uterine Myoma Position-based Radiofrequency Ablation (UMP-b RFA): 36 months follow-up clinical outcomes

Fasciani, Alessandro; Turtulici, Giovanni; Pedullà, Alessio; Sirito, Rodolfo

doi:10.1016/j.ejogrb.2022.12.006

Cited by 9 publications

(7 citation statements)

References 13 publications

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“…The title and abstract of manuscripts were screened, resulting in 19 studies considered potentially eligible to be included in the review. After the evaluation of the full text, 16 studies were excluded: 11 manuscripts [ [14][15][16][17][18][19][20][21][22][23][24] were articles without disaggregated data; 1 molecular and in silico study [25]; 2 articles not considering the removal of type 3 myoma [26,27]; 1 study where type 3 myoma removal was performed by other techniques [28]; 1 additional study was not in the English language [29]. Finally, a total number of three studies [30][31][32] that met the abovementioned inclusion criteria were included in the present systematic review (Figure 1).…”

Section: Study Selectionmentioning

confidence: 99%

Feasibility and Surgical Outcomes of Hysteroscopic Myomectomy of FIGO Type 3 Myoma: A Systematic Review

Etrusco

Laganà

Chiàntera

et al. 2023

JCM

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The latest classification from the Fédération Internationale de Gynécologie et d’Obstétrique (FIGO) has reclassified type 3 myomas, changing their classification from intramural to submucosal. While hysteroscopic myomectomy is considered the gold standard treatment for patients experiencing symptoms from submucosal myomas, there are currently no specific guidelines available for managing type 3 myomas, and the optimal surgical approach remains uncertain. Methods: The search for suitable articles published in English was carried out using the following databases (PROSPERO ID CRD42023418602): MEDLINE, EMBASE, Global Health, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register), Health Technology Assessment Database, Web of Science and search register. Only original studies reporting data on hysteroscopic myomectomy of type 3 myoma were considered eligible. The main outcomes investigated were the effectiveness and feasibility of hysteroscopic myomectomy and reproductive outcomes after surgical treatment. Results: Two hundred and sixty-one studies were screened and nineteen of these were read for eligibility. Three studies encompassing 56 patients in total were included. Among the overall population studied, three patients needed an additional procedure to completely remove the myoma and five cases of post-surgical synechiae were recorded. No complications were reported. Of 42 patients wishing for pregnancy, the cumulative live birth rates before and after the hysteroscopic myomectomy were 14.3% and 42.9%, respectively. Conclusions: Hysteroscopic myomectomy appears to be a safe and feasible approach. Nevertheless, data reported in the literature are extremely scarce and based on studies with few patients enrolled. New evidence is needed to assess the safety and effectiveness of hysteroscopic treatment for FIGO type 3 myomas.

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Section: Study Selectionmentioning

confidence: 99%

Feasibility and Surgical Outcomes of Hysteroscopic Myomectomy of FIGO Type 3 Myoma: A Systematic Review

Etrusco

Laganà

Chiàntera

et al. 2023

JCM

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“…69 This technology enables the ablation of ULs by inducing coagulative necrosis using ultrasound-guided laparoscopic or transcervical devices. 70,71 Radiofrequency myolysis (RFM) has…”

Section: Radiofrequency Ablationmentioning

confidence: 99%

“…and were treated using vaginal and hysteroscopic approaches (8 and 3 cases, respectively). 71 The positive surgical outcomes, low complication rates compared to alternative treatments, ease of execution, and successful pregnancies following RFM suggest that it may be a viable method for treating type 3 ULs. 79,80 However, it is important to note that RFM is not applicable to all types of ULs (it is not recommended for FIGO type 7 ULs), 75 and its effectiveness for infertile patients has not been investigated, as women desiring pregnancy have been excluded from all RFM studies.…”

Section: Radiofrequency Ablationmentioning

confidence: 99%

“…In 2012, it was approved by the Food and Drug Administration as a treatment for symptomatic ULs 69 . This technology enables the ablation of ULs by inducing coagulative necrosis using ultrasound‐guided laparoscopic or transcervical devices 70,71 . Radiofrequency myolysis (RFM) has shown promising results in reducing symptoms associated with ULs, such as menstrual bleeding and chronic pelvic pain 72–74 …”

Section: Putative Alternative Surgical Treatments To Hysteroscopymentioning

confidence: 99%

“…After 36 months, they observed a reduction in UL volume and diameter of 90.20% and 55.70%, respectively (mean diameter at baseline was 3.86 cm). Among the treated ULs, 11 were classified as type 3 and were treated using vaginal and hysteroscopic approaches (8 and 3 cases, respectively) 71 …”

Section: Putative Alternative Surgical Treatments To Hysteroscopymentioning

confidence: 99%

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The challenge of FIGO type 3 leiomyomas and infertility: Exploring therapeutic alternatives amidst limited scientific certainties

Favilli,

Mazzon,

Etrusco

et al. 2023

Intl J Gynecology & Obste

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Uterine leiomyomas (ULs) are non‐cancerous tumors composed of smooth muscle cells that develop within the myometrium and represent the most prevalent pathological condition affecting the female genital tract. Despite the volume of available research, many aspects of ULs remain unresolved, making it a “paradoxical disease” where the increase in available scientific literature has not been matched by an increase in solid evidence for clinical management. Fertility stands at the top of the list of clinical issues where the role of ULs is still unclear. The leiomyoma subclassification system, released by the International Federaion of Gynecology and Obstetrics (FIGO) in 2008, introduced a new and more effective way of categorizing uterine fibroids. The aim was to go beyond the traditional classification “subserosal, intramural and submucosal”, facilitating a detailed examination of individual ULs impact on the female reproductive system. The “type 3 UL” is a special type of myoma, characterized by its complete myometrial development while encroaching the endometrium. It is a unique “hybrid” between a submucous and an intramural UL, that may exert a detrimental “double hit” mechanism, which is of particular interest in patients wishing pregnancy. To date, no robust evidence is available regarding the management of type 3 ULs. The aim of this narrative review is to provide a comprehensive overview of the physiopathological mechanisms that type 3 UL may exert on fertility, and to present new perspectives that may help us to better understand both the need for and the methods of treating this unique type of fibroid.

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The impact of fibroid treatments on quality of life and mental health: a systematic review

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Brennan

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Uterine Myoma Position-based Radiofrequency Ablation (UMP-b RFA): 36 months follow-up clinical outcomes

Cited by 9 publications

References 13 publications

Feasibility and Surgical Outcomes of Hysteroscopic Myomectomy of FIGO Type 3 Myoma: A Systematic Review

Feasibility and Surgical Outcomes of Hysteroscopic Myomectomy of FIGO Type 3 Myoma: A Systematic Review

The challenge of FIGO type 3 leiomyomas and infertility: Exploring therapeutic alternatives amidst limited scientific certainties

The impact of fibroid treatments on quality of life and mental health: a systematic review

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