Type of Uterine Fibroids

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Treatment Options

• Myomectomy : There are several types of myomectomy, an operation that removes fibroids and leaves the reproductive organs completely intact, and mostly functional.
  
• Myolysis : Myolysis is a controversial procedure. The fibroids are not removed, rather, the blood supply to the myoma is reduced by coagulation of the vessels (through electric coagulation, cryoscopy, or laser). This causes the fibroids to shrink in size. This treatment can cause adhesions, weakness in the uterine wall, or future uterine rupture during pregnancy. Potential cancer can be missed. This procedure is still being studied for thorough evaluation.
  
• MRgFUS : MR controlled Incision less surgery via thermal ablation of Targeted Tissues
  
• Hysterectomy : With or without removal of the ovaries, Hysterectomy is the most radical approach to the treatment of fibroids. In the absence of a cancerous condition a supra-cervical hysterectomy - which leaves the cervix in place - can be a better choice.
  
• Uterine Artery Embolization : Process by which the blood flow to the uterus is interrupted. A catheter is inserted into the leg vein and follows it into the uterine artery. A chemical (poly-vinyl alcohol) is then injected into the uterine artery (process of embolization) which interrupts blood flow to both the womb and any fibroids within it. This is intended to cause myomas to shrink, stunt their source of nourishment, and prevent them from growing in the future. Embolization is not performed by a gynecologist. The procedure is executed by an interventional radiologist, usually referred by the gynecologist treating the patient. There are many misconceptions about the safety and efficacy of the procedure.
  
• Drug Treatments (GnRH) : Hormone therapy can slow fibroid growth before surgery. But with secondary effect.
  
• No Treatment : Doing nothing is also an option and often a good recommendation if symptoms are not severe.
  

Uterine Fibroid Treatment Options

See the table

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MR Guided Focused Ultrasound (MRgFUS), exclusive to GE MR systems, is achieved through a partnership between GE MR and InSightec’s ExAblate, an innovative technology that engages high intensity ultrasound beams to heat and destroy fibroid tissue. This groundbreaking non-invasive surgical solution engages MR to visualize patient anatomy, map the volume of fibroid tissue to be treated, and monitor the temperature of the uterine tissue after heating. Our focused ultrasound generates heat, ablating tissue only at the focal point.
The MR guidance focus benefits are various:

• No hospitalization
• Limited conscious sedation
• No radiation
• Return next day to normal activity
• Low rate of complication
• Reduced cost

Video Explanation

• Ablating tissue at focal point

• ExAblate Solution (TV News)

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MRgFUS uterine fibroid treatments worldwide (as of April 18, 2005)

• Symptomatic in 25% of women
• Up to 250 000 women in US undergo surgery each year
• 70% reported significant symptom relief
• Low rate of complications (less than 3%)
• 1200 symptomatic women treated worldwide
• 700 under clinical protocol
• 500 in commercial treatments

Efficacy: patient satisfaction

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Efficacy: economics

Disability Days (1st 30 days post-treatment)

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• Fewer days of missed work
• Quicker return to normal activity
• Fewer days in bed

Safety :

• Less than 3% complications (leg pain, skin burn)
• Recent studies show decrease % of events
• All complications resolved w/o intervention
• No new complications appear > 1 month after procedure

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• FDA Approves New Device to Treat Uterine Fibroids
• European Regulatory approval for uterine fibroids treatments

• More about MRI
• Insightec (http://www.insightec.com)
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