TY - JOUR
T1 - Evaluation of uterine patency following transcervical uterine fibroid ablation with the Sonata system (the OPEN clinical trial)
AU - Bongers, Marlies
AU - Quinn, Stephen D.
AU - Mueller, Michael D.
AU - Kraemer, Bernhard
AU - Tuschy, Benjamin
AU - Sutterlin, Marc
AU - Lasmar, Ricardo Bassil
AU - Chudnoff, Scott
AU - Thurkow, Andreas
AU - De Wilde, Rudy Leon
PY - 2019/11
Y1 - 2019/11
N2 - Objective: Standard transcervical fibroid treatment via hysteroscopic myomectomy can result in a significant rate of intrauterine adhesiogenesis. The primary objective of this study was to document the incidence of de novo uterine adhesions after transcervical fibroid ablation (TFA) of symptomatic uterine fibroids with the Sonata (R) system.Study design: In this European postmarket prospective, multicenter, single-arm interventional trial, patients were eligible for inclusion if they chose TFA with the Sonata System for symptomatic fibroids and had at least 1 type 1, type 2 or type 2-5 myoma. The presence or absence of intrauterine adhesions was assessed by diagnostic hysteroscopy at baseline and at 6 weeks post-ablation. The hysteroscopy videos were scored by a committee of 3 independent readers.Results: A total of 6 sites enrolled 37 patients. Fifty fibroids with a mean diameter of 3.4 +/- 1.8 cm (range 1-8 cm) were ablated. Of the 37 enrolled subjects, 35 completed the study follow-up and 2 electively withdrew from the study prior to the completion of study follow-up. Thirty-four out of 35 pairs of baseline and 6-week hysteroscopies were evaluated by the independent readers with none having de novo adhesions at 6 weeks after treatment with Sonata, including 6 patients with apposing myomata. One patient was excluded from the analysis due to an unevaluable hysteroscopy video.Conclusion: Intrauterine adhesiogenesis was not seen post-TFA with the Sonata system. These results suggest the potential for adhesiogenesis after TFA, including in women with apposing submucous and/or transmural myomata, may be minimal. (C) 2019 Elsevier B.V. All rights reserved.
AB - Objective: Standard transcervical fibroid treatment via hysteroscopic myomectomy can result in a significant rate of intrauterine adhesiogenesis. The primary objective of this study was to document the incidence of de novo uterine adhesions after transcervical fibroid ablation (TFA) of symptomatic uterine fibroids with the Sonata (R) system.Study design: In this European postmarket prospective, multicenter, single-arm interventional trial, patients were eligible for inclusion if they chose TFA with the Sonata System for symptomatic fibroids and had at least 1 type 1, type 2 or type 2-5 myoma. The presence or absence of intrauterine adhesions was assessed by diagnostic hysteroscopy at baseline and at 6 weeks post-ablation. The hysteroscopy videos were scored by a committee of 3 independent readers.Results: A total of 6 sites enrolled 37 patients. Fifty fibroids with a mean diameter of 3.4 +/- 1.8 cm (range 1-8 cm) were ablated. Of the 37 enrolled subjects, 35 completed the study follow-up and 2 electively withdrew from the study prior to the completion of study follow-up. Thirty-four out of 35 pairs of baseline and 6-week hysteroscopies were evaluated by the independent readers with none having de novo adhesions at 6 weeks after treatment with Sonata, including 6 patients with apposing myomata. One patient was excluded from the analysis due to an unevaluable hysteroscopy video.Conclusion: Intrauterine adhesiogenesis was not seen post-TFA with the Sonata system. These results suggest the potential for adhesiogenesis after TFA, including in women with apposing submucous and/or transmural myomata, may be minimal. (C) 2019 Elsevier B.V. All rights reserved.
KW - Fibroids
KW - Intrauterine adhesions
KW - Radiofrequency ablation
KW - Sonata
KW - Intrauterine sonography
KW - GUIDED RADIOFREQUENCY ABLATION
KW - VOLUMETRIC THERMAL ABLATION
KW - FOCUSED ULTRASOUND SURGERY
KW - OUTCOMES
KW - LEIOMYOMA
KW - WOMEN
U2 - 10.1016/j.ejogrb.2019.09.013
DO - 10.1016/j.ejogrb.2019.09.013
M3 - Article
VL - 242
SP - 122
EP - 125
JO - European Journal of Obstetrics & Gynecology and Reproductive Biology
JF - European Journal of Obstetrics & Gynecology and Reproductive Biology
SN - 0301-2115
ER -