Treatment Options for Uterine Fibroids Using Microwave and Radiofrequency

Minimally invasive thermal ablation therapies, including microwave ablation (MWA) and radiofrequency ablation (RFA), have emerged as effective alternatives to traditional surgical approaches for the management of symptomatic uterine fibroids. These techniques offer advantages such as reduced pain, minimal blood loss, and quicker recovery times. This mini-review integrates current evidence with clinical experience to evaluate the efficacy, safety, procedural characteristics, and cost-effectiveness of MWA and RFA, with additional comparisons to high-intensity focused ultrasound (HIFU) and magnetic resonance imaging-guided focused ultrasound surgery. Two clinical cases are presented to illustrate the application and outcomes of combining MWA or RFA with hysteroscopic resection. Available data suggest that MWA provides the shortest treatment duration and broad applicability, while RFA offers high ablation rates, especially for large or hypervascular fibroids. In contrast, HIFU is noninvasive and better tolerated but requires longer procedural time and has more stringent patient selection criteria. Treatment decisions should be individualized based on fibroid characteristics, patient preferences, and available resources. With appropriate patient selection and procedural expertise, these minimally invasive methods can significantly improve symptom control and quality of life.