Managing Uterine Fibroids: Alternatives to Hysterectomy

William H. Parker, MD

Disclosures

July 20, 2012

In This Article

MRI-Guided Focused Ultrasonography (MRgFUS)

Heat created by focused ultrasonography can denature protein and cause cell death. MRI can direct the targeting of fibroids and monitor therapy by assessing the temperature of treated tissue.[29]

The advantages of MRgFUS are very low morbidity and very rapid recovery, with return to normal activity in 1 day. Currently, the procedure is not recommended for women wishing future fertility.

Recent studies of larger treatment areas than the US Food and Drug Administration's initial allowance reported that the average volume reduction was 31% ± 28%.[30] An evaluation of clinical outcomes found a significant reduction in symptoms in 71% of women at 6 months after treatment but in only 50% at 12 months.[31]Subsequent myomectomy, uterine artery embolization, or hysterectomy was necessary in 28% of the women. Of interest, because women actively sought treatment with MRgFUS and no control group (sham MRgFUS) was included, a placebo effect cannot be ruled out in these studies.

As the technology continues to develop, further studies will be needed to evaluate the risks and efficacy of MRgFUS in the treatment of uterine fibroids.

Consider the Options

Uterine fibroids are commonly found in women of reproductive age. Most women do not require treatment because fibroids are benign. For bothersome symptoms that interfere with quality of life, many treatment options exist and should be considered before the decision to perform hysterectomy.

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