TOPLINE

Among women with symptomatic uterine fibroids, both laparoscopic radiofrequency ablation (RFA) and myomectomy produced lasting symptom relief and improved health-related quality of life (HRQOL) over 2 years. Myomectomy showed early advantages on some measures, but the difference was not clinically meaningful by 2 years.

METHODOLOGY

• Researchers reported 2-year findings of a prospective cohort study (ULTRA) comparing changes in the severity of symptoms of uterine fibroids and HRQOL after laparoscopic RFA vs myomectomy.
• They included 401 premenopausal women older than 21 years with symptomatic uterine leiomyomas (mean age, 39.22 years) recruited from multiple sites in the US.
• The women underwent either laparoscopic RFA or myomectomy. A total of 386 women completed at least one follow-up assessment.
• The women completed a questionnaire for fibroid-related symptoms and HRQOL, along with a 36-item general health survey.
• The women were followed up for up to 24 months with assessments every 6 months.

TAKEAWAY

• Women who underwent RFA and those who underwent myomectomy both experienced reductions in the severity of their symptoms and improvements in HRQOL over 24 months.
• Women who underwent myomectomy had a 5.27-point greater reduction in the symptom severity score than those who underwent RFA (P = .028). The benefit was significant at 3, 6, and 12 months but not at 18 and 24 months.
• Women who underwent myomectomy also had a 6.62-point greater improvement in HRQOL than those who underwent RFA (P = .011). The advantage persisted through 18 months but not at 24 months.
• Based on previously published thresholds, women in both groups achieved clinically meaningful improvements in the severity of their symptoms and HRQOL, but the between‑group difference did not meet these thresholds.

IN PRACTICE

"[The] findings suggest that both procedures provide substantial and durable improvements in symptoms and HRQOL, supporting individualized treatment selection based on patient goals, clinical characteristics, and shared decision-making," the researchers wrote.

SOURCE

The study was led by Antoinette Allen, MD, MAS, of Weill Cornell Medical College in New York City. It was published online on September 22 in Obstetrics & Gynecology.

LIMITATIONS

The study was not randomized. Women in the two treatment groups had different characteristics of fibroids at the start. Women who underwent myomectomy joined the study later than those who underwent RFA.

DISCLOSURES

Hologic provided funding for the study through an investigator-initiated grant to the University of California, San Francisco. The authors did not report any conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.