What is Acessa radiofrequency ablation?

Acessa radiofrequency ablation (RFA) is a minimally invasive surgical treatment for uterine fibroids that uses controlled radiofrequency energy to shrink fibroids while preserving the uterus. It offers an alternative to hysterectomy and major surgery for women seeking symptom relief with shorter recovery times.

The procedure is approved in the UK, the US and other regions, and is typically offered to women with symptomatic fibroids who wish to avoid more invasive options.

How Acessa works

Acessa is performed using a laparoscopic (keyhole) approach under general anaesthetic.

The procedure involves:

1. Making two or three small abdominal incisions

2. Using laparoscopic ultrasound to locate fibroids within the uterine wall

3. Inserting a thin probe directly into each fibroid

4. Delivering radiofrequency energy, which heats and destroys fibroid tissue
   

The treated fibroids are not removed. Instead, they shrink gradually over several months, reducing pressure, bleeding and pain.

Because the surrounding uterine tissue is largely unaffected, the uterus remains intact.

What symptoms it treats

Acessa is designed to treat fibroid-related symptoms, including:

• Heavy or prolonged menstrual bleeding

• Pelvic pain or pressure

• Urinary frequency or constipation caused by fibroid bulk

• Pain during intercourse
  

It is suitable for many fibroid types, including intramural and subserosal fibroids, but not all cases. Submucosal fibroids that protrude into the uterine cavity are often better treated using other techniques.

How it differs from other fibroid treatments

Compared with hysterectomy

• Preserves the uterus

• Shorter hospital stay

• Faster recovery

• No loss of fertility potential (although pregnancy data remain limited)
  

Compared with myomectomy

• Less bleeding during surgery

• No uterine suturing

• Reduced risk of adhesions

• Shorter operating time in many cases
  

Compared with uterine artery embolisation (UAE)

• Targets individual fibroids rather than cutting off blood supply to the whole uterus

• Lower risk of post-embolisation pain syndrome

• Avoids radiation exposure
  

Recovery and outcomes

Most patients:

• Go home the same day or after one night

• Return to normal activities within 3–7 days

• Experience gradual symptom improvement over three to six months
  

Clinical studies show significant reductions in fibroid volume and sustained symptom relief for the majority of patients at follow-up.

Fertility considerations

Acessa is uterus-sparing, but it is not primarily marketed as a fertility treatment. Pregnancies have been reported after the procedure, but long-term fertility data are still emerging.

For women actively planning pregnancy, treatment choice should be discussed carefully with a specialist, weighing Acessa against myomectomy.

Risks and limitations

Acessa is generally considered safe, but potential risks include:

• Infection

• Bleeding

• Injury to nearby organs (rare)

• Incomplete symptom relief if untreated fibroids remain
  

Not all women are suitable candidates, and imaging is essential to determine eligibility.

Why Acessa matters

For decades, hysterectomy has been the most common surgical treatment for fibroids, despite many women wishing to preserve their uterus. Acessa represents a shift towards less invasive, organ-preserving care, giving patients more control over their treatment choices.

As awareness grows and long-term data continue to develop, radiofrequency ablation is increasingly seen as a key option in the modern management of uterine fibroids.