Laparoscopic Fibroid Ablation vs Myomectomy: 2-Year Data
Symptomatic uterine fibroids significantly affect health and everyday productivity. Today, laparoscopic radiofrequency ablation offers a minimally invasive alternative to traditional surgical resection. Gynecologists frequently evaluate this technique alongside conventional myomectomy. Recent evidence now clarifies how these two approaches compare over two full years.
Evaluating Laparoscopic Radiofrequency Ablation in the ULTRA Study
The multicenter ULTRA study prospectively evaluated premenopausal women with symptomatic uterine fibroids. In this investigation, researchers compared laparoscopic radiofrequency ablation directly with laparoscopic or abdominal myomectomy. The trial enrolled 401 participants who completed validated health surveys over 24 months. Furthermore, researchers used propensity-weighted models to minimize selection bias. Notably, more than half of the cohort identified as Black, addressing a critical demographic burden.
Symptom Relief and Quality of Life Outcomes
Both interventions delivered substantial and sustained clinical benefits across the two-year period. Specifically, patients reported major reductions in symptom severity and notable improvements in quality of life. Myomectomy produced slightly larger numerical gains in symptom scores at two years. However, these numerical score differences did not reach minimal clinically important difference thresholds. Interim six-month scores favored myomectomy for daily activities. Nevertheless, those temporary functional differences completely disappeared by 24 months.
Clinical Implications for Fibroid Management
Consequently, these 24-month findings demonstrate that both therapeutic approaches provide excellent long-term relief. Surgeons can confidently offer laparoscopic ablation as an effective uterine-preserving solution. In addition, ablation provides a quicker recovery and avoids deep uterine incisions. In contrast, myomectomy remains valuable when clinicians must achieve complete anatomic excision. Ultimately, clinicians should guide surgical decisions by prioritizing individual patient goals and reproductive plans.
Frequently Asked Questions
Q1: Does laparoscopic radiofrequency ablation relieve fibroid symptoms as effectively as myomectomy?
Yes, both techniques offer sustained and significant symptom relief over two years. Although myomectomy showed minor score advantages, the differences remained below clinically meaningful thresholds.
Q2: What is the main clinical advantage of laparoscopic radiofrequency ablation?
The procedure delivers thermal energy directly into fibroids to induce coagulative necrosis. Consequently, patients experience minimal tissue disruption, lower blood loss, and rapid postoperative recovery.
Q3: How do functional outcomes compare between both procedures over time?
Initially, myomectomy provided slightly greater improvements in physical activities at six months. However, these functional differences equalized, demonstrating equivalent quality of life at 24 months.
References
- Allen A et al. Effectiveness of Laparoscopic Radiofrequency Ablation of Uterine Leiomyomas Compared With Myomectomy on Symptoms and Health-Related Quality of Life. Obstet Gynecol. 2026 Sep 22. doi: 10.1097/AOG.0000000000006432. PMID: 42771818.
- Allen A, Schembri M, Parvataneni R, et al. Pregnancy Outcomes After Laparoscopic Radiofrequency Ablation of Uterine Leiomyomas Compared With Myomectomy. Obstet Gynecol. 2024;143(6):803-810.
- Chen J, Gao Y, Lin G, Wang J, Kong F, Zou M. Comparison of thermal ablative methods and myomectomy for the treatment of fibroids: a systematic review and meta-analysis. Int J Hyperthermia. 2021;38(1):1621-1632.
