New strategies in the management of uterine fibroids: advances in ablation techniques
Keywords:
ABLACIÓN POR RADIOFRECUENCIA; MIOMA; NEOPLASIAS UTERINAS; TÉCNICAS DE ABLACIÓN; ULTRASONIDO ENFOCADO DE ALTA INTENSIDAD DE ABLACIÓN.; RADIOFREQUENCY ABLATION; MYOMA; UTERINE NEOPLASMS; ABLATION TECHNIQUES; HIGH-INTENSITY FOCUSED ULTRASOUND ABLATION.; ABLAÇÃO POR RADIOFREQUÊNCIA; MIOMA; NEOPLASIAS UTERINAS; TÉCNICAS DE ABLAÇÃO; ABLAÇÃO POR ULTRASSOM FOCALIZADO DE ALTA INTENSIDADE.Abstract
Introduction: uterine fibroids represent the most prevalent benign pelvic neoplasm in women, associated with a significant burden of gynecological symptoms and impaired quality of life.
Objective: to critically evaluate the scientific evidence on the efficacy and safety of ablation techniques, particularly radiofrequency ablation, as a treatment for symptomatic uterine fibroids.
Methods: a systematic review of the scientific literature was conducted across multiple databases, using an algorithm with keywords and Boolean operators to identify relevant sources. Selected studies, after applying rigorous inclusion and exclusion criteria, were critically assessed for timeliness, methodological quality, and thematic relevance, and coherently integrated into the final synthesis of the review.
Development: the reviewed literature demonstrates that ablation, especially radiofrequency and MRI-guided focused ultrasound, induces an average volumetric reduction of 45–55 % in fibroids. Concurrently, clinically relevant improvement in major symptoms is observed, with reductions in menstrual bleeding (~70 %) and pelvic pain (~60 %). The safety profile is favorable, with mainly minor transient complications reported.
Conclusions: ablation is consolidated as a minimally invasive, effective, and safe alternative for the management of fibroids, offering advantages in uterine preservation and recovery times. Long-term studies are required to assess recurrence and optimize therapeutic protocols.
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