A 41-year-old woman with extensive adenomyosis has undergone a minimally invasive Microwave Ablation (MWA) procedure at the Institute of Human Reproduction (IHR), Guwahati, without laparoscopy or an abdominal incision.
The procedure was performed on September 5 by Dr Deepak Goenka using real-time ultrasound guidance. According to the institute, it is the first procedure of its kind reported in Northeast India.
The woman, who had been married for five years, was undergoing treatment for infertility and severe menstrual pain. She had previously undergone an attempted laparoscopic procedure that was later converted to open surgery.
Medical investigations at IHR found extensive adenomyosis measuring around 8×7 cm in the posterior wall of the uterus. Her uterus was significantly enlarged, with a reported volume of approximately 504 cc, compared with an average uterine volume of about 50 cc.
Adenomyosis occurs when tissue similar to the uterine lining grows into the muscular wall of the uterus. The condition can cause severe menstrual pain, heavy bleeding and enlargement of the uterus, and may affect fertility in some women.
In this case, doctors opted for a uterus-preserving approach using ultrasound-guided MWA instead of conventional surgery to remove the affected tissue.
The procedure was carried out under general anaesthesia and took around 30 minutes. A thin microwave applicator was guided into the affected portion of the uterus using continuous ultrasound imaging, after which microwave energy was used to destroy the abnormal tissue.
Doctors said that for appropriately selected patients, treating significant adenomyosis while preserving the uterus may form part of an individualised fertility treatment plan, including preparation for IVF where clinically appropriate.
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