Could Transcervical Radiofrequency Ablation Become a Therapy Option for Focal Adenomyosis?

Background/aim: Adenomyosis is a common gynecological disease characterized by the presence of ectopic endometrial tissue (endometrial stroma and glands) within the myometrium. It is classified into two main types: diffuse and focal. The aim of this study was to present the outcomes of patients with focal adenomyosis following treatment with transcervical radiofrequency ablation.

Patients And Methods: This was a retrospective analysis of patients treated with the Sonata System. A total of 574 cases were analyzed, all performed at two centers in Germany: Academic Hospital Cologne Weyertal and Hospital Böblingen.

Results: Thirty patients with focal adenomyosis were treated with transcervical radiofrequency ablation. All surgeries were performed without any complications. The mean surgery's time was 30.7 minutes, while the mean ablation time was 8.5 minutes. At the time of this report, 27 patients had returned for follow-up. 89% of patients reported improvement in their symptoms. No patient reported a worsening of their symptoms. The procedure reduced the average focal lesion size from 4.4 cm to 2.8 cm. No postoperative complications were observed. All patients reported satisfaction with the procedure.

Conclusion: Transcervical radiofrequency ablation appears to be an effective approach for treating adenomyosis. The Sonata System, in particular, offers notable advantages, making it a potentially valuable alternative to conventional procedures like hysterectomy and tissue excision. This minimally invasive approach preserves the uterus, providing a less invasive and more patient-centered treatment option for adenomyosis.