Are Hysterectomies for Fibroids Necessary?

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Are Hysterectomies for Fibroids Necessary?

Are Hysterectomies for Fibroids Necessary?

Richard CHUDACOFF MD

Nevada, Las Vegas
Obstetrics & Gynecology

Has special expertise in certain sickness

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* Date : 02-26-2008 - 04:19 AM (5904 days ago),

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Are Hysterectomies for Fibroids Necessary?

Uterine fibroids, also called myomas or leiomyomas, account for at least one-third of all hysterectomies in the US. These benign muscle tumors of the uterus are most common in women in their 30’s and 40’s, but can be found as early as the teenage years. Symptoms are slow to manifest and can include heavy cycles, pain with periods, low back discomfort, pelvic pressure, loss of urine with coughing, jumping and sneezing, and pain with intercourse. Myomas can also interfere with pregnancies and deliveries.

Treatment for symptomatic uterine fibroids, from least to most invasive, includes medical management; ExAblate/MRgFUS; uterine artery embolization (think of a string tightly wrapped around your finger); myomectomy; and hysterectomy.

Described as the ideal surgery, ExAblate completely destroys targeted tissue without causing damage to adjacent tissue. MR imaging identifies targeted tissue and detects suitable access routes for the ultrasound waves. The ultrasound energy harmlessly penetrates normal tissue and then focuses on the targeted tissue, inducing cell death. Afterwards MRI contrast scans verify the effectiveness of the treatment. (For those claustrophobic patients, your head is outside, and you are lying chest down on pillows.)

This effective, safe, non-invasive, closed loop procedure eradicates the targeted tissue with minimal discomfort and recovery time. So effective and novel, the ExAblate table topped the list of the US FDA’s Office of Device Evaluation Annual Report Fiscal Year 2005 for new devices approved in 2004.

The energy created by the focused ultrasound beams results in a localize heating. In about one second this thermal ablation destroys all structural and enzymatic proteins sensitive to temperatures greater than 54 degrees C. In fact all mammalian cells, regardless of function and structure, are destroyed above this temperature. (At 44 degrees C (111 degrees F) our cells will die in only 4 hours, which is why we recommend staying out of the sun during the hot summer days.)

Perhaps this is an easier explanation. As children we used magnifying glasses to focus sunlight on to leaves or sticks. Held long enough the object of attention would even catch on fire. Fortunately sunlight does not penetrate very far into the body. Ultrasound waves easily pass through tissue. Serial, focused, adjacent spots destroy the fibroids in about a 3-4 hour treatment and a one hour recovery time. You can literally have your procedure in the morning, and be back to work in the afternoon, incision free!

What happens to this fibroid? By denaturing the proteins, the building blocks of cells, fibroids becomes soft and avascular; no more blood flow to that area of treatment. Mushy is the term most patients say if they can feel the change. Symptoms tend to resolve rapidly, in some cases while patients are lying on the table. The fibroids do not go away, but degenerate, shrink and no longer become an uncomfortable factor in life.

If you have symptomatic fibroids, this may be the option for you.

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