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Case Reports
. 2024 Feb 16;12(5):980-987.
doi: 10.12998/wjcc.v12.i5.980.

Abnormal uterine bleeding successfully treated via ultrasound-guided microwave ablation of uterine myoma lesions: Three case reports

Toshiyuki Kakinuma  1 , Kaoru Kakinuma  2 , Rora Okamoto  2 , Kaoru Yanagida  2 , Michitaka Ohwada  2 , Nobuhiro Takeshima  2
Affiliations
Case Reports

Abnormal uterine bleeding successfully treated via ultrasound-guided microwave ablation of uterine myoma lesions: Three case reports

Toshiyuki Kakinuma et al. World J Clin Cases. .

Abstract

Background: Microwave endometrial ablation (MEA) is a minimally invasive treatment method for heavy menstrual bleeding. However, additional treatment is often required after recurrence of uterine myomas treated with MEA. Additionally, because this treatment ablates the endometrium, it is not indicated for patients planning to become pregnant. To overcome these issues, we devised a method for ultrasound-guided microwave ablation of uterine myoma feeder vessels. We report three patients successfully treated for heavy menstrual bleeding, secondary to uterine myoma, using our novel method.

Case summary: All patients had a favorable postoperative course, were discharged within 4 h, and experienced no complications. Further, no postoperative recurrence of heavy menstrual bleeding was noted. Our method also reduced the myoma's maximum diameter.

Conclusion: This method does not ablate the endometrium, suggesting its potential application in patients planning to become pregnant.

Keywords: Case report; Dysmenorrhea; Fertility preservation; Heavy menstrual bleeding; Microwave; Uterine myoma.

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Conflict of interest statement

Conflict-of-interest statement: All the authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Transvaginal ultrasound tomography. A: The schema for this procedure. Transvaginal ultrasound tomography was used to identify the feeding vessels of the uterine myomas via the color Doppler method. Using a needle-shaped deep coagulation electrode, the feeding vessels were directly ablated with microwaves at 2.45 GHz; B: Intraoperative transvaginal ultrasound tomography. Transvaginal ultrasound tomography using the color Doppler method was performed to identify the feeding vessels to the uterine myomas (arrow); C: A transvaginal ultrasound-guided microwave ablation of the feeding vessels to the uterine myomas using a needle-shaped deep coagulation electrode is depicted as a hyperechoic area (arrows).
Figure 2
Figure 2
Magnetic resonance imaging examination of the pelvis of before the procedure. Magnetic resonance imaging examination of the pelvis of before the procedure. A: Case 1; Sagittal T2-weighted image showed a 65 mm solid mass; B: Case 2; Sagittal T2-weighted image showed a 35 mm solid mass; C: Case 3; Sagittal T2-weighted image showed a 22 mm and 15 mm solid mass.
Figure 3
Figure 3
Magnetic resonance imaging examination of the pelvis of post the procedure. A: Case 1; The uterine myoma [International Federation of Gynecology and Obstetrics (FIGO) classification system 5] reduced from 65 mm to 27 mm by postoperative month 3; B: Case 2; The uterine myomas (FIGO classification system 5) reduced from 35 mm to 20 mm by postoperative month 3; C: Case 3; The uterine myomas (FIGO classification system 5) reduced from 22 mm and 15 mm to 15 mm and 13 mm by postoperative month 3.s
See this image and copyright information in PMC

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