Efficacy of multiple microwave endometrial ablation technique for menorrhagia resulting from adenomyosis.

AIM: Conventional microwave endometrial ablation (MEA) can be insufficient to control menorrhagia resulting from adenomyosis. We compared the standard single ablation technique with multiple MEA - repeating ablation three times in the same region - in patients with adenomyosis and menorrhagia.

MATERIAL AND METHODS: We performed single MEA in 18 patients and multiple MEA in seven patients between 2007 and 2013. We compared the efficacy of single and multiple MEA using a visual analog scale (VAS) for menorrhagia, dysmenorrhea, and patient satisfaction. We also evaluated the incidence of menorrhagia recurrence, amenorrhea, and procedure complications in relation to patients' clinical factors.

RESULTS: VAS scores for improved menorrhagia and patient satisfaction were significantly higher in the multiple MEA group than in the single MEA group; however, the operative time was longer in the multiple-treatment group. There were no statistical differences between groups in hemoglobin levels, VAS improvement for dysmenorrhea, menorrhagia recurrence, frequency of complications, or amenorrhea rate.

CONCLUSION: Multiple MEA successfully controls menorrhagia from adenomyosis and achieves a higher satisfaction rate than single MEA.