Clinical Efficacy of Percutaneous Microwave Ablation in Treating Uterine Fibroids: A Comprehensive Systematic Review and Meta-Analysis

Purpose: The objective of this systematic review and meta-analysis was to assess the clinical efficacy of percutaneous microwave ablation (PMWA) therapy for treating uterine fibroids and to explore regional variations in its effectiveness. Methods: PubMed, Google Scholar, and CochraneLibrary were searched using keywords such as “leiomyoma,” “fibroid,” and “microwave ablation” to identify clinical trials and observational studies involving women with symptomatic uterine fibroids treated with PMWA therapy. Data on the outcomes of symptom severity, quality of life, fibroid volume, and hemoglobin concentration were extracted to calculate weighted mean differences (WMD) with 95% confidence intervals. Subgroup analyses based on study type and location were conducted. The quality and risk of bias of the included studies were evaluated using the National Institutes of Health quality assessment tools. Heterogeneity was assessed using Higgins I² statistics. Results: Out of 1,068 initial records, 14 studies comprising 754 patients with symptomatic uterine fibroids were included. There was a significant reduction in symptom severity (WMD = –33.3; 95 %CI: −41.16, −25.46; p < 0.001; I² = 99 %) and fibroid volume (WMD = −89.26 cm³; 95 % CI: −130.64, −47.87; p < 0.01; I² = 99 %)., along with a significant improvement in quality of life (WMD = 27.21; 95 % CI:21.70,32.72; p < 0.01; I² = 91 %) and hemoglobin concentration (WMD = 3.20 g/dl; 95 %CI:2.71,3.69; p < 0.01;I² = 83 %). Subgroup analysis identified study location as a significant moderator for fibroid volume reduction, with Asian studies showing a greater decrease than European studies. Conclusion: The analysis suggests that PMWA therapy is an efficacious treatment for uterine fibroids, with consistent outcomes in both Asian and European populations. However, high heterogeneity among the included studies limits the interpretation of results.