Ablación con radiofrecuencia de los miomas uterinos
"Radiofrequency ablation of fibroids is a novel treatment with fantastic short- and long-term results."
DR. ÁLVARO RUIZ ZAMBRANA SPECIALIST. GYNAECOLOGY AND OBSTETRICS DEPARTMENT
What is radiofrequency ablation of fibroids?
Radiofrequency ablation (RFA) is a minimally invasive treatment for symptomatic uterine fibroids that preserves the uterus. Instead of removing the fibroid, its tissue is destroyed from the inside using controlled heat. Guided by imaging, a thin electrode is inserted into the fibroid; the energy precisely raises the temperature, causes necrosis, and in the following weeks the body reabsorbs that tissue, reducing the fibroid’s volume and relieving bleeding, pain, or pressure symptoms.
The procedure is usually performed on an outpatient basis, with sedation or regional/general anesthesia depending on the approach and the patient’s characteristics. Recovery is quick. Not all fibroids are candidates: size, number, and location determine eligibility, as well as reproductive goals and the absence of contraindications.
The Department of Gynecology and Obstetrics, in collaboration with the Interventional Radiology Unit, has extensive experience performing this treatment. Each case is assessed with advanced imaging technology and under strict safety and quality standards, achieving excellent short- and long-term outcomes.
When is radiofrequency ablation of a fibroid indicated?
Symptoms that may improve
Radiofrequency ablation is a treatment indicated for women who suffer from symptomatic fibroids. The goal is to relieve or eliminate the discomfort caused by these benign tumors. Among the symptoms that may improve significantly are:
- Abnormal uterine bleeding: This is the most common symptom. Ablation has proven to be highly effective in reducing heavy menstrual bleeding (menorrhagia or hypermenorrhea). In many cases, it completely resolves bleeding problems.
- Pelvic pain and pressure: The treatment relieves pelvic pain, the feeling of pressure or heaviness in the lower abdomen, back pain, and pain during sexual intercourse (dyspareunia).
- Compression symptoms: By reducing the size of the fibroids, pressure on nearby organs such as the bladder and rectum decreases. This improves symptoms such as frequent urination (pollakiuria), difficulty fully emptying the bladder, constipation, or abdominal bloating.
- Anemia: As a direct consequence of reducing heavy bleeding, RFA helps correct iron-deficiency anemia (low iron levels in the blood due to excessive blood loss).
Types of fibroids eligible for treatment
The suitability of a fibroid for treatment with radiofrequency ablation (RFA) is decided on an individual basis and depends mainly on its location, size, and number.
RFA is especially useful when the fibroid is located within the uterine muscle or when, even if protruding into the cavity, most of it remains within the uterine wall. On the other hand, fibroids that grow extensively outward from the uterus or those that are very large may not be the best indication for this technique. If the fibroid is entirely inside the uterine cavity, it is usually better treated with a hysteroscopy (a vaginal approach that does not require abdominal incisions).
As for size, the usual practice is to treat fibroids up to 7–10 cm, adjusted to each patient’s anatomy and the team’s experience. The earlier the treatment (when the fibroid is smaller), the simpler and more effective it tends to be. If several fibroids are present, it is possible to treat more than one in the same procedure; however, when there are many, it may be preferable to plan alternatives or combined strategies to maximize safety and clinical benefit. In all cases, the decision is made after an evaluation with ultrasound and/or MRI and a clear explanation of the options.
Is this technique suitable for you?
Our team will analyze your situation and provide you with personalized guidance
Fibroids and pregnancy desire:
we can help
Radiofrequency ablation (RFA) can be an option to preserve the uterus and reduce symptoms. By treating the fibroid from within while preserving the myometrium, the waiting time to try for pregnancy is usually shorter than after surgeries that leave a uterine scar.
In many cases, attempting pregnancy can be considered just a few months later (around 4–6 months), compared with the 12–18 months usually recommended after a myomectomy, always according to an individual medical assessment.
Our Department of Gynecology and Obstetrics will provide you with a personalized evaluation and a safe plan to achieve pregnancy.
How is radiofrequency ablation performed?
How is the ablation performed
Radiofrequency ablation is a minimally invasive procedure performed in the operating room for safety, usually on an outpatient basis. Most patients undergo sedation (general anesthesia is rarely required), which allows for a quick recovery.
Access to the fibroid is achieved through the vagina and/or the cervix, without abdominal incisions or visible scars. Throughout the procedure, the specialist uses real-time ultrasound to locate the fibroid, precisely guide a thin electrode into it, and deliver energy only where needed. When necessary, multiple fibroids can be treated in the same session.
The procedure usually takes less than an hour. After a short observation period, the patient returns home the same day and, in most cases, can resume normal activities the following day.
In the weeks that follow, the body gradually reabsorbs the treated tissue and the fibroid decreases in size, leading to relief from bleeding and pelvic pressure.
The Gynecology Department team will schedule a follow-up plan to monitor the response and address any questions during recovery.
One of the main advantages of radiofrequency ablation is the quick recovery it allows. Being a minimally invasive technique, the impact is much lower compared with traditional surgery.
Recovery
- Outpatient procedure: discharge after 2–3 hours of observation.
- Return to normal activities within 24–48 hours; return to work is usually faster than with conventional surgeries.
Pain and pain relief
- The procedure does not cause significant pain or bleeding.
- Mild, period-like discomfort in a minority of cases (~5%), which resolves within the first week.
- Ibuprofen or acetaminophen prescribed at discharge is usually sufficient.
Expected menstrual changes
- Clear reduction in menstrual bleeding in the weeks/months following the procedure.
- Possible spotting or watery discharge for 1–8 weeks (normal).
- Occasional expulsion of small fragments of the treated fibroid, especially if it extended into the uterine cavity.
Warning signs (contact your medical team)
- Persistent or high fever.
- Severe abdominal pain not relieved with prescribed medication.
- Heavy or uncontrollable bleeding.
- Foul-smelling vaginal discharge.
Serious complications are rare; careful patient selection and meticulous technique further minimize the risk.
Where do we do it?
IN NAVARRE AND MADRID
The Department of Gynecology and Obstetrics of the
of the Clínica Universidad de Navarra
Comprehensive care that includes a wide range of consultation and treatment options from regular preventive screening to the most advanced diagnostic and treatment options for obstetric and gynecological problems at all ages.
The department also offers routine pregnancy monitoring that includes a variety of diagnostic and screening procedures to identify potential problems of the fetus as well as its proper growth and development.
Diseases we treat
- Gynecological Cancer
- Prenatal diagnosis
- Endometriosis
- Urinary and fecal incontinence
- Masas anexiales
- Menopause
- Polycystic ovary syndrome
- Uterine Myomas
Why at the Clinica?
- Highly specialized team of doctors, nurses and midwives.
- Reproduction and Fertility Unit.
- Pregnancy follow-up with a personalized delivery.
- All the comfort, with the guarantee and safety of a hospital with the most advanced equipment.
Our team of professionals
Specialists in Plastic Surgery with experience in performing abdominoplasties
