ABSTRACT
OBJECTIVE: To describe transvaginal radiofrequency ablation of myomas (TRAM) in ten keys steps. DESIGN: Video article STATEMENT OF CONSENT: The patient included in this video gave her consent for its publication online, including social media, the journal website, scientific literature websites (such as PubMed, ScienceDirect, Scopus, etc ) and other applicable sites. SUBJECT: A 38-year-old woman presenting with menometrorrhagia and consequent chronic anemia (hemoglobin 8.5 g/dl) caused by a cervical myoma measuring 51 cm3. Initially, a cervico-vaginal embolization was performed but without any improvement in symptoms. Given the complex position of the myoma (close proximity to the uterine arteries), as well as the patient's desire for future pregnancies, a TRAM was proposed. EXPOSURE: Not applicable. MAIN OUTCOME MEASURES: Volume of myoma and menometrorrhagia 6 months following treatment. RESULT(S): Not applicable CONCLUSION(S): TRAM is a quick, simple, minimally invasive and easily reproducible technique. It could be an interesting alternative to the conventional laparoscopic and open surgical treatments of myomas. There is lack of high-quality data establishing TRAM safety in infertility and pregnancy. The only available radiofrequency ablation device in the United States has specific language stating that this procedure is not recommended for women considering future pregnancy.
