IHR Guwahati Uses Ultrasound-Guided Microwave Ablation to Treat Adenomyosis
The 30-minute ultrasound-guided procedure treated an approximately 8×7 cm area of adenomyosis without laparoscopy or an abdominal surgical incision.
GUWAHATI- A minimally invasive procedure for treating adenomyosis has been performed at the Institute of Human Reproduction (IHR), Guwahati, using real-time ultrasound-guided Microwave Ablation (MWA) without laparoscopy or an abdominal surgical incision.
The procedure was performed by Dr Deepak Goenka on a 41-year-old woman who was seeking treatment for infertility and severe menstrual pain.
The significant aspect of the procedure was its uterus-preserving approach, with microwave energy used to treat the affected adenomyotic tissue under continuous ultrasound guidance, without conventional abdominal surgery.
According to the information provided by IHR, the patient had been married for five years and had previously undergone an attempted laparoscopic procedure that was eventually converted to open surgery.
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Investigations at IHR found extensive adenomyosis measuring approximately 8×7 cm in the posterior wall of the uterus. Her uterus was also markedly enlarged, with a reported volume of approximately 504 cc, compared with an average uterine volume of around 50 cc.
Ultrasound-guided treatment
Adenomyosis is a condition in which tissue similar to the lining of the uterus grows into the muscular wall of the uterus. The condition can be associated with painful menstruation, heavy menstrual bleeding and an enlarged uterus, and may also be associated with difficulty becoming pregnant.
Treating extensive adenomyosis can present particular challenges when a patient wishes to preserve the uterus and fertility.
In this case, the medical team opted for real-time ultrasound-guided Microwave Ablation as a uterus-preserving treatment approach.
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The procedure was performed under general anaesthesia and took approximately 30 minutes. Using continuous ultrasound imaging, a thin microwave applicator was guided into the affected area of the uterus.
Microwave energy was then applied to heat and destroy the targeted abnormal adenomyotic tissue in a controlled manner.
According to IHR, neither laparoscopy nor an abdominal surgical incision was required for the procedure.
Potential role in fertility care
Adenomyosis can also be relevant to fertility treatment, including IVF, in some patients. The information provided by IHR states that, in appropriately selected cases, treatment of significant adenomyosis while preserving the uterus may form part of an individualised fertility-treatment strategy, including preparation for IVF when clinically indicated.
The procedure performed at IHR represents an application of minimally invasive treatment for an appropriately selected patient with extensive adenomyosis.
The case also highlights the potential role of uterus-preserving approaches for women who wish to consider pregnancy in the future, particularly where conventional surgery may present challenges.
