Applications of the 1470 nm diode laser in the outpatient Management of symptomatic submucosal uterine fibroids

Abstract

Uterine leiomyomas, also known as fibroids, are the most common tumors in women of reproductive age, often associated with abnormal uterine bleeding and reproductive issues. This study evaluated the efficacy of the 1470 nm Diode Laser for performing hysteroscopic myolysis in the office. A prospective longitudinal case series study was conducted with 10 patients: women over 18 years old, diagnosed with 1 or 2 symptomatic submucosal fibroids (grade 0-2 FIGO) ≤5 cm in size. Patients were informed about the procedure, risks, and benefits, and signed an informed consent document. A 1470 nm Diode Laser with an 800-micron fiber was used, achieving optimal water absorption and the desired vaporization effect. The average procedure duration, from the insertion of the hysteroscope into the uterine cavity to the completion of fibroid core coagulation and vaporization, was 9.6 minutes. Intraoperative blood loss was estimated to be insignificant in all patients. No procedures were aborted or interrupted. The average pain level immediately after the procedure, documented on the visual analog scale, was 1 in 40% of patients, 2 in 30%, 4 in 20%, and 5 in 10%. Six patients had FIGO class 2 submucosal fibroids, three had class 0, and one had class 1. The average fibroid volume before the procedure was 2.75 mm (0.5-6.0 mm), and the average fibroid volume after the procedure was 0.10 mm. Of the four patients evaluated postmyolysis at 8 weeks, only one had a significantly reduced fibroid from 2.5 cc to 0.4 cc; the remaining three showed no ultrasound evidence of uterine fibroids, indicating a favorable response to laser vaporization. No pre- or post-surgical complications were reported.