MICROWAVE ABLATION for adenomyosis :Odisha's 1st case by DR GSS Mohapatra in Sept2024 shown on Otv)

This video shows the first ever microwave ablation in the state of Odisha in sept 2024 by Dr GSS MOHAPATRA who is also the state's only microwave ablation expert. This video was telecast originally on Otv in sept 2024.

Dr GSS MOHAPATRA
Endometriosis Expert and Excision Specialist

Director of advanced gynaec laparoscopy and endometriosis
Ankura hospital for women and children bhubaneshwar

Visiting consultant Apollo hospital bbsr
Ex HOD of Amri hospital bhubaneshwar.

MD( O&G)
Odisha's first gynaec robotic surgeon
Odisha's 1st vnotes surgeon
Odisha's 1st microwave ablation expert
Trained in advanced endometriosis ( France, Germany & Italy)
Call 9937776329,9776822222 for appointment
website : www.drgssmohapatra.com
"YES TO EVERYONE , NO TO NO ONE"
Our social media links:
  / drgssmohapatra  
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Microwave Ablation in the Treatment of Adenomyosis

1. Introduction

Adenomyosis is a gynecological condition characterized by the presence of endometrial tissue within the myometrium, leading to uterine enlargement, heavy menstrual bleeding, and severe dysmenorrhea. Traditional treatment options include hormonal therapy and hysterectomy; however, minimally invasive techniques have gained prominence in recent years. Among these, microwave ablation (MWA) has emerged as a promising therapy. Microwave ablation uses electromagnetic waves to generate heat and induce coagulative necrosis of adenomyotic tissue while preserving surrounding healthy myometrium. This approach is minimally invasive, often performed under ultrasound guidance, and aims to relieve symptoms without compromising uterine integrity.


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2. LUMWA

(I assume “LUMWA” here refers to the local uterine microwave ablation technique).
Local uterine microwave ablation involves the insertion of a microwave probe into the adenomyotic lesion under imaging guidance (ultrasound or MRI). The probe emits electromagnetic energy, generating temperatures of approximately 60–100°C within the target tissue. This heat destroys adenomyotic foci, reduces uterine volume, and minimizes abnormal bleeding and pain. The procedure is typically done under conscious sedation, is outpatient-friendly, and has a shorter recovery period compared to surgical excision.


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3. How Microwave Ablation Helps in Adenomyosis to Relieve Symptoms

Microwave ablation relieves the symptoms of adenomyosis through several mechanisms:

1. Thermal destruction of ectopic endometrial tissue – Ablation causes coagulative necrosis of adenomyotic foci, reducing the aberrant tissue causing pain and bleeding.


2. Reduction in uterine volume – As the adenomyotic tissue shrinks, uterine bulk symptoms such as pressure and discomfort improve.


3. Alleviation of dysmenorrhea and menorrhagia – By eliminating the ectopic endometrial tissue within the myometrium, the hypercontractile response during menstruation is reduced.


4. Minimal invasiveness – Preservation of the surrounding myometrium reduces complications and allows quicker recovery compared to hysterectomy or surgical excision.




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4. Role in Success of IVF After Microwave Ablation

Preserving the uterus is crucial for patients desiring pregnancy. Microwave ablation has shown promise in improving fertility outcomes, particularly in women undergoing in vitro fertilization (IVF):

Reduction in inflammatory environment – Adenomyosis creates a pro-inflammatory uterine milieu that may impair embryo implantation. Ablation reduces inflammatory foci, creating a more receptive endometrium.

Improved uterine anatomy – By shrinking adenomyotic lesions and normalizing uterine contours, implantation chances may improve.

Preservation of endometrium and myometrium – Unlike hysterectomy, MWA maintains uterine integrity, allowing IVF attempts post-procedure.


Clinical studies indicate that women with adenomyosis who undergo microwave ablation may experience better implantation rates, higher clinical pregnancy rates, and reduced miscarriage rates during IVF cycles.


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5. Conclusion

Microwave ablation represents a safe, minimally invasive, and effective option for the management of adenomyosis. It provides significant relief from dysmenorrhea and menorrhagia while preserving the uterus for future fertility. Additionally, MWA can improve IVF outcomes by reducing uterine inflammation and restoring a more favorable environment for embryo implantation. As technology and technique advance, microwave ablation is poised to become an essential tool in the multidisciplinary management of adenomyosis, particularly in women desiring fertility preservation.

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