Efficacy of ultrasound-guided microwave ablation combined with chemical ablation for uterine fibroid management

Background: Uterine fibroids are the most common benign tumors of the female reproductive tract and often cause menorrhagia, pelvic pain, and infertility. Ultrasound-guided microwave ablation (MWA) has gained recognition as a minimally invasive, uterus-preserving therapy; however, incomplete ablation may compromise long-term outcomes. This study aimed to evaluate the efficacy and safety of MWA combined with chemical ablation (CA) compared with MWA alone in patients with symptomatic fibroids. Methods: This retrospective cohort study included women aged 18-55 years with imaging-confirmed uterine fibroids treated between January 2021 and December 2024. Patients were allocated to either the MWA+CA group (n=126) or the MWA group (n=108). Both groups underwent ultrasound-guided percutaneous ablation procedures. Treatment efficacy was assessed based on fibroid volume reduction, cure rates, and recurrence. Statistical analyses included independent-samples t-tests for continuous variables and chi-square tests for categorical variables. Results: Both treatment groups showed significant reductions in fibroid volume. The MWA+CA group experienced a more pronounced reduction, with a mean volume decrease from 33.64 ± 8.20 cm³ to 10.37 ± 2.25 cm³ (p < 0.001), compared to the MWA group, where the volume decreased from 32.36 ± 7.18 cm³ to 15.36 ± 3.27 cm³ (p < 0.001). The overall effective rate in the MWA+CA group was 98.4%, significantly higher than the 88.9% in the MWA group (p = 0.002). Recurrence rates were significantly lower in the MWA+CA group (1.6% vs. 8.3%, p = 0.015). Conclusions: Ultrasound-guided MWA combined with CA is more effective in reducing fibroid volume and preventing recurrence compared to MWA alone. This combination offers a promising treatment option for symptomatic uterine fibroids, with no significant increase in adverse reactions. Larger, multicenter, prospective studies are needed to further validate these findings.