Laparoscopic Radiofrequency Ablation of Fibroids
Educational information only, not medical advice. Talk with a qualified clinician before making decisions about your care.
Uterine fibroids (also called myomas) are non-cancerous growths that originate from the uterus. By age 50, an estimated 70% of white women and over 80% of Black women will have developed fibroids; about 25–30% have symptoms significant enough to seek treatment. Symptoms can include heavy menstrual bleeding, prolonged periods, pelvic pain, pressure on other organs (called bulk symptoms), or planning your life around periods. Symptoms often depend on the size and location of the fibroids in the uterus.
Radiofrequency ablation (RFA) of fibroids is a minimally invasive, uterus-preserving treatment that uses controlled radiofrequency energy to heat and destroy fibroid tissue, causing fibroids to shrink over time. Two FDA-cleared RFA systems are currently used in the United States: a laparoscopic approach (performed through small abdominal incisions, e.g., the Acessa system) and a transcervical approach (performed through the vagina and cervix, with no abdominal incisions, e.g., the Sonata system). Both approaches use real-time ultrasound guidance to target individual fibroids. RFA is generally an outpatient procedure with a short recovery period. Long-term durability and effects on future fertility are still being studied; women planning future pregnancy should discuss this option carefully with a surgeon experienced in fibroid RFA.
Why is this procedure performed?
Laparoscopic radiofrequency ablation of fibroids is used for women with symptomatic fibroids who want to save their uterus.
Benefits of the surgery:
- Saves the uterus
- No surgical cuts on the uterus
- Faster recovery than traditional abdominal surgery done through a large incision
Alternatives to this procedure can include:
- Not having any treatment
- Medication to manage bleeding
- Procedure to decrease blood supply to the uterus (uterine artery embolization)
- Removal of fibroids (myomectomy)
- Removal of uterus (hysterectomy)
What are the risks of this procedure?
There is a small chance of having a complication or problem when you have surgery. Your risk could be higher if you have had surgery before or have other medical conditions. Some risks include:
- Bleeding during or after the surgery
- Infection
- Injury to your bladder, intestines, or other structures near your uterus
- Blood clots in your legs or lungs
- Hernia (weakness and a tear in the wall of your abdomen)
- Need to switch to a laparotomy (surgery through one large surgical cut)
- Up to a 30% chance of recurrence of fibroids requiring further treatment or repeat surgery
- Complications in pregnancy including requiring a C-section for delivery and need for closer monitoring in pregnancy (please consult an obstetrician early in pregnancy)
What should I expect after surgery?
Everyone recovers at a different pace after surgery. Many patients are able to get back to most of their usual activities by one to two weeks after surgery. Common symptoms after laparoscopic treatment of fibroids include:
- Irregular vaginal bleeding
- Fatigue or sleepiness from anesthesia
- Pain or cramping in your stomach and soreness from your surgical cuts
- Shoulder pain
- Constipation (difficulty emptying bowels)
Do not put anything in your vagina for at least two weeks (no tampons or sexual intercourse).
When should I call my doctor?
Serious problems after laparoscopy are uncommon, but notify your surgeon if you develop:
- Difficulty breathing or shortness of breath
- Heavy vaginal bleeding
- Pain not controlled by your pain medications
- Severe nausea and vomiting
- A fever of 100.4°F or higher
- Trouble urinating or having a bowel movement
Patient information sheet
Download the printable AAGL patient information sheet for this procedure.
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