An obstetrician-gynecologist from Mayo Clinic recommends focused ultrasound as a treatment option for women with uterine fibroids. According to a Clinical Practice Review published in the April 23, 2015 edition of The New England Journal of Medicine, Elizabeth A. Stewart, MD of the Mayo Clinic reports that focused ultrasound should be made available as a uterine-conserving treatment for uterine fibroids.
Stewart’s article emphasizes that despite the high prevalence of fibroids, exceeding 80% among black women and nearly 70% among white women, there are few randomized trials to guide treatment decisions. While concern has been raised regarding the overuse of hysterectomies—which account for nearly three quarters of all fibroid procedures—the article discusses several alternatives for women who wish to retain their uterus and to avoid the potential complications and recovery time associated with surgery.
“Uterine-conserving therapy should be an available option for women even if there is no plan for childbearing,” Stewart said in an announcement. “Although myomectomy, a surgical procedure to remove uterine fibroids, is the traditional alternative to hysterectomy, there are other options for medical and interventional treatment.”
Stewart’s article contains an algorithm for managing fibroids, with focused ultrasound included as a treatment for women with symptoms relating to an enlarged uterus. Focused ultrasound is a noninvasive FDA-approved treatment for fibroids which uses high-intensity sound waves to heat and destroy the fibroid while leaving the surrounding uterine tissue intact. The outpatient procedure involves no incisions, and enables many women to return to normal activity in 1 to 2 days.
The first focused ultrasound system was approved in the US in 2004, and the treatment has been successfully performed on more than 12,000 women with fibroids worldwide, according to the Focused Ultrasound Foundation. For more information, see the NEJM article.