09/10/2025
Microwave ablation (MWA) is an emerging, minimally invasive treatment for adenomyosis, and it works through a combination of thermal destruction of adenomyotic tissue and preservation of normal uterine structure. Let’s break down how it helps with both pain relief and fertility improvement:
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🔹 1. Mechanism of Microwave Ablation
Microwave ablation uses microwave energy (2.45 GHz) delivered via a thin probe inserted into the uterus under ultrasound guidance.
The microwaves generate heat (typically 60–100 °C), which causes coagulative necrosis (cell death) of adenomyotic tissue. Over time, the necrotic tissue shrinks and is resorbed or replaced by fibrous tissue.
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🔹 2. How It Relieves Pain
Pain in adenomyosis arises mainly from:
Invasion of endometrial glands into the myometrium
Increased uterine volume and contractility
Inflammatory cytokines and prostaglandin release
MWA relieves pain by:
1. Destroying ectopic endometrial glands within the myometrium → no more cyclic bleeding inside muscle.
2. Reducing uterine volume → less pressure and fewer contractions.
3. Decreasing prostaglandin production → fewer painful cramps.
4. Reducing local inflammation and nerve irritation.
Clinical studies have shown significant reduction in dysmenorrhea (pain) and menorrhagia (heavy bleeding) after MWA, often within 1–3 months.
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🔹 3. How It Helps to Conceive
1. Preservation of the uterus and endometrium
Unlike hysterectomy or deep resection, MWA selectively destroys adenomyotic tissue but spares normal endometrium and uterine wall integrity.
2. Improved uterine environment
Reduces inflammation and abnormal uterine contractility that interfere with embryo implantation.
3. Normalization of uterine shape and perfusion
Shrinkage of adenomyotic lesions restores uterine cavity contour and blood flow.
4. Hormone balance restoration
By removing hormonally active adenomyotic foci, local estrogen dominance may reduce.
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🔹 4. Comparison with Other Treatments
Treatment Pain Relief Fertility Preservation Recurrence Notes
GnRH agonists Temporary Yes High Hormonal side effects
UAE (embolization) Good Moderate Moderate May impair ovarian reserve
HIFU Good Yes Moderate Non-invasive, longer procedure
MWA Excellent Good Low–Moderate Precise, minimally invasive
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🔹 5. Ideal Candidates
Symptomatic focal or localized adenomyosis
Women wanting uterine preservation or future fertility
Failed medical therapy or unsuitable for surgery
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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)
www.drgssmohapatra.com
Call 9937776329,9776822222 for appointment
