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. 2023 Aug 26;11(24):5653-5659.
doi: 10.12998/wjcc.v11.i24.5653.

Effectiveness of treating menorrhagia using microwave endometrial ablation at a frequency of 2.45 GHz

Toshiyuki Kakinuma  1 , Ayaka Kaneko  2 , Kaoru Kakinuma  2 , Yoshio Matsuda  2 , Kaoru Yanagida  2 , Nobuhiro Takeshima  2 , Michitaka Ohwada  2
Affiliations

Effectiveness of treating menorrhagia using microwave endometrial ablation at a frequency of 2.45 GHz

Toshiyuki Kakinuma et al. World J Clin Cases. .

Abstract

Background: Microwave endometrial ablation (MEA) is a minimally invasive treatment for menorrhagia. It has been covered by the national insurance in Japan since April 2012, and its demand has been increasing as the importance of women's health has advanced in society.

Aim: To examine the efficacy of MEA as a treatment option for menorrhagia.

Methods: In this study, we retrospectively analyzed 76 patients who underwent MEA between January 2016 and March 2020 in our department. MEA was performed in the lithotomy position, under general anesthesia, and with transabdominal ultrasound guidance, including the entire endometrial circumference while confirming endometrial coagulation. The Microtaze AFM-712 and the Sounding Applicator CSA-40CBL-1006200C were used for MEA, and the endometrium was ablated using a Microtaze output of 70 W and coagulation energization time of 50 s per cycle. The visual analog scale (VAS) was used to evaluate menorrhagia, menstrual pain, and treatment satisfaction. Additionally, the hemoglobin (Hb) levels before and after MEA and associated complications were investigated.

Results: The average age of the patients was 44.8 ± 4.0 years. While 14 patients had functional menorrhagia, 62 had organic menorrhagia, of whom 14 had endometrial polyps, 40 had uterine fibroids, and 8 had adenomyosis. The VAS score before MEA and 3 and 6 mo after the procedure were 10, 1.3 ± 1.3, and 1.3 ± 1.3, respectively, for menorrhagia and 10, 1.3 ± 1.8, and 1.3 ± 1.8, respectively, for menstrual pain, both showing improvements (P < 0.001). The MEA Hb level significantly improved from 9.2 ± 4.2 g/dL before MEA to 13.4 ± 1.2 g/dL after MEA (P = 0.003). Treatment satisfaction was high, with a VAS score of 9.6 ± 0.7. Endometritis was observed in one patient after surgery and was treated with antibiotics.

Conclusion: MEA is a safe and effective treatment for menorrhagia.

Keywords: Adenomyosis; Dysmenorrhea; Endometrial ablation techniques; Leiomyoma; Menorrhagia; Microwaves; Visual analog scale.

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Conflict of interest statement

Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.

Figures

Figure 1
Figure 1
Changes in visual analog scale score for menorrhagia following microwave endometrial ablation. A: All cases; B: Those with functional menorrhagia; C: Those with endometrial polyps; D: Those with uterine fibroids; E: Those with adenomyosis. Values are expressed as the mean, with error bars representing the standard deviation. aSignificantly diferent between before surgery and each group, P < 0.001.
Figure 2
Figure 2
Changes in visual analog scale score for dysmenorrhea following microwave endometrial ablation. A: All cases; B: Those with functional menorrhagia; C: Those with endometrial polyps; D: Those with uterine fibroids; E: Those with adenomyosis. Values are expressed as the mean, with error bars representing the standard deviation. aSignificantly different between before surgery and each group, P < 0.001.
Figure 3
Figure 3
Comparison of blood hemoglobin levels before and after microwave endometrial ablation. A: All cases; B: Those with functional menorrhagia; C: Those with endometrial polyps; D: Those with uterine fibroids; E: Those with adenomyosis. Values are expressed as the meas, with error bars representing the standard deviation. MEA: Microwave endometrial ablation.
See this image and copyright information in PMC

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