Microwave endometrial ablation with microwave myolysis for symptomatic myomas and adenomyosis

The feasibility of ultrasonically guided transcervical microwave myolysis for symptonatic uterine myomas and adenomyosis was examined. After completion of microwave endometrial ablation, a 14 gauge guiding needle was transcervically introduced to the uterine cavity and inserted into the deep adenomyosis or myoma tissue under ultrasonography using a transvaginal probe with a puncture attachment. An inner needle of the guiding needle was replaced by the microwave applicator 1.6mm in diameter. In two cases of myoma, a submucous node 6 cm in size and an intramural node 7 cm in size irradiated by microwaves became avascular in Gd-enhanced MRI. In a case of adenomyosis with a uterus over a newborn's head in size, the adenomyosis lesion was necrotized by microwaves. The patient became amenorrheic and the uterus decreased in size by 40%. No complications were encountered. Ultrasonically guided microwave myolysis is feasible and a promising treatment.