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Uterine fibroids (leiomyomas or
myomas) are the most common neoplasms of the female pelvis. These benign tumors
arise from the smooth muscle cells of the uterus, are generally oval shaped,
are often highly vascular, and occur in up to 50% of women of reproductive age.
Their size can range from few millimeters to 10 cm or more. Fibroids,
particularly when small, may be entirely asymptomatic. Important symptoms
include abnormal gynecologic hemorrhage, heavy or painful periods, abdominal
discomfort or bloating, painful defecation, backache, urinary frequency or
retention, and in some cases, infertility. There may also be pain during
intercourse, depending on the location of the fibroid.
Uterine fibroids are often multiple,
and if a uterus contains too many leiomyoma to count, it is referred to as
“diffuse uterine leiomyomatosis.”
Measures of the clinical success of
fibroid treatment are subjective and thus evaluated by the patient in terms of
rapid and long-lasting improvement in the symptoms that caused her to seek
treatment (decrease in pain, bladder, or bowel symptoms or reduction in vaginal
bleeding) along with a minimum of adverse effects from the treatment itself.
MRI-HIFU Fibroids Treatment Options in India
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The mainstay of treatment of
symptomatic fibroids has been surgery, which could be either myomectomy
(removal of the fibroid), or hysterectomy (removal of the uterus). Of these,
only hysterectomy ensures that the patient will never suffer from fibroids
again, but is a rather radical option for a benign tumour that only requires
symptomatic relief. Also, a hysterectomy is followed by a lengthy recovery
period before the patient returns to normal activities. Both hysterectomy as
well as myomectomy can also be done laparoscopically (key-hole surgery),
dramatically reducing the post- operative morbidity. However, even these are
invasive techniques, and the risks and possible complications of surgery and
anesthesia remain a constant threat.
The search for non-invasive
techniques to provide the patient with relief from this otherwise non-
threatening illness led to other minimally invasive options like Uterine Artery
Embolisation, and Radio- Frequency Ablation which however had limited efficacy,
and considerable adverse effects like excruciating post-treatment pain.
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The procedure is gaining wide acceptance because of the ease of use, exemplary safety and minimal disruption in the patients' daily routine. This is a day-care surgery, where the patient reports to the clinic for the procedure, undergoes the procedure and is able to walk out and go home after the procedure. The patient is able to go back to her regular routine within the next 24 hours, and the symptomatic relief obtained with this procedure is comparable to that following a myomectomy in the long term
Advantages of Nonsurgical Fibroid Embolization
On average, 85-90 percent of women who have had the procedure experience significant or total relief of heavy bleeding, pain and/or bulk-related symptoms.
Requires only a tiny nick in the skin (No surgical incision of abdomen).
Recovery is shorter than from hysterectomy or open myomectomy.
All fibroids are treated at once, which is not the case with myomectomy. There has been no observed recurrent growth of treated fibroids in the past 9 years.
- Uterine fibroid embolization involves virtually no blood loss or risk of blood transfusion.
- Many women resume light activities in a few days and the majority of women are able to return to normal activities (including exercise) within a week. If the presenting complaint was excess vaginal bleeding, 87-90% of cases experience resolution within 24hours.
