OP07.09: Initial clinical study of ultrasound‐guided percutaneous microwave ablation of adenomyosis

To evaluate the feasibility and clinical effect of ultrasound-guided percutaneous microwave ablation (PMA) of adenomyosis. Six patients with adenomyosis as volunteer in our institution were treated with ultrasound-guided PMA. Before ablation ultrasound-guided percutaneous biopsy was done and then, microwave needle with inner-water cooling was implanted in the lesion along the biopsy needle track to ablate the lesion with the power setting at 50W. The uterine fibroid symptom, health-related quality of life questionnaire (UFS–QOL) and enhanced MRI were obtained pre- and after ablation respectively to evaluate the clinical effect and the ablation zone. After ablation the patients were intensively observed for 24 hours and followed up for 2 months for side effects and complications. The age of patients was 37–44 years, mean 39 ± 5 years. Four patients had completed child-bearing, the other two undesiring fertility. Pre-ablation the UFS–QUL symptom scores was 9.4–54.2 mean 32.9 ± 19.5 and health–related life quality score (HLQS) was 16.3–62.9 mean 41.6 ± 20.3. The baseline mean diameter of the uterus body ranged from 5.6 to 10.8 cm mean 8.2 ± 2.6 cm. After ablation the mean diameter of ablation zone was 2.5–4.2 cm, average 3.1 cm with no enhancement in ceMRI. All the patients complained no obvious discomfort. None of complications or side effect was observed during and after ablation. At one month after treatment the uterus size shrink to (4.4–9.2) cm mean (6.8 ± 2.4) cm P⩽0.05. UFS–QUL symptom score decreased to 3.0–42.3 (mean 17.7 ± 14.6) and the HLQS increase to 34.1–99.2 (mean 69.0 ± 33.1). All the patients had normal menstrual onset in the very month after they received ablation and the symptoms relieved obviously or disappeared. Ultrasound-guided PMA of adenomyosis is a safe and effective method with minimal invasion. It may be a positive option for the patients refusing operation to remove uterus. The long term clinical results need to be evaluated with large example and long term follow up.