By: Allison Stevens for Fibroids1Severe uterine fibroids may require a hysterectomy. In fact, more than one-third of all hysterectomies are due to uterine fibroids. But the need for a hysterectomy is devastating news to any woman with hopes of a future pregnancy. Chinese researchers report good news for these women after testing the safety and effectiveness of an alternative procedure. The procedure, high intensity focused ultrasound (HIFU), not only reduces the size of fibroids, but also preserves fertility.
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Questions to ask your doctor before committing to a procedure to treat uterine fibroids:
What are the benefits of this procedure?
Can I still have children after the procedure?
What are the risks involved? Are there common complications I should know about?
What is the typical recovery time after the procedure?
What are my other options?
Where can I find more information? |
The Research
Researchers performed HIFU in 119 women with uterine fibroids. The women, ages 26 to 58, had a combined total of 187 fibroids, each ranging in diameter from 1.5-9.8 centimeters. HIFU was performed with sedation to prevent pain. The whole fibroid was divided into slices by using ultrasonographic images (no cuts were involved). By scanning the HIFU beam in successive sweeps from the deep to shallow regions of the fibroid, the targeted regions on each slice were completely ablated. This was done for each slice.
Study results published in the 2007 issue of Journal of Ultrasound Medicine report a reduction in fibroid size in 164 (87.7 percent) of the 187 treated fibroids, stable size was seen in 12 fibroids (6.4 percent); and an increase in size was seen in 11 fibroids(5.9%).
Patient follow-up was at one, three, six, and 12 months after the procedure, and, on average, fibroid size decreased with each follow-up. Average reduction in tumor size as a percentage of initial tumor volume at one month was 21.2 percent and by 12 months that number was up to a 48.7 percent reduction in tumor size.
Complications
Most patients felt minor abdominal pain during the procedure, but as soon as the procedure stopped, the pain vanished. Researchers reported that, “among the 119 patients treated with HIFU, an extremely low complication rate was observed.”
However, some of the subjects did report minor complications. For example, seven patients had low-grade fevers that persisted for one to three days after the procedure and nine patients had minimal vaginal bleeding, which also lasted one to three days. Other complications reported were lower abdominal pain, cramping, and vaginal discharge.
In this study, there was one report of failure. A 49-year-old subject had worsening symptoms at follow-up and required a hysterectomy three months after HIFU treatment, for heavy menstrual bleeding.
Other Treatments
HIFU is not the only hysterectomy alternative. All of the treatment alternatives have some drawbacks. For example, myomectomy can be used only with fibroids in specified locations and sizes. Uterine artery embolization (UAE) can treat a wider range in terms of location and size of fibroids, post-procedure pain and fever are common.
Conclusion
Researchers conclude that “these findings validate HIFU ablation as a robust option for conservative treatment of uterine fibroids in patients who are unable to tolerate hysterectomy and want to preserve their fertility.” But keep in mind that because this study followed patients for only 12 months after surgery and is fairly new in the treatment of uterine fibroids, more research is needed to determine long-term effects.
