The side effects from uterine fibroids cause many women to suffer from pain and discomfort as well as other debilitating symptoms, keeping them from enjoying many social occasions. These are benign growths that happen in the uterus and can be microscopic in size or grow to the size of a small basketball. Symptoms include pain, discomfort, heavy bleeding, anemia, constipation, swollen abdomen and urinary tract issues. The symptoms, while not life-threatening, are very uncomfortable and many women also experienced decreased fertility when the fibroids distort the structure of the uterus or block the entrance to the Fallopian tubes.
Treatment for these fibroids has been limited to hysterectomies and endometrial ablation, both of which effectively terminate the ability of a woman to conceive again. Improvements in the surgical procedures have opened up several other options which may decrease the size and scarring caused by the fibroids.
Women now have another treatment option, laser, to decrease their pain, discomfort and changes to their lifestyle. In a study published in the Journal of Human Reproduction researchers described a study using laser treatment developed from St. Mary’s Hospital, London and the London School of Hygiene And Tropical Medicine. The research technique does not require general anesthesia and allows the procedure to be done as an outpatient. (1)
During this particular laser treatment the surgeon uses magnetic resonance imaging (MRI) every three seconds to guide the laser which is used to “zap” the fibroids with heat energy in order to kill them.
This type of laser treatment has been shown to decrease the size of the fibroids by up to one third only three months after the procedure. Women who returned for further evaluation note 40% reduction in the size of their uterine fibroids after one year. Researchers have used this procedure on individuals who have completed their families but want to avoid the side effects of a hysterectomy. Hysterectomies will often cause a surgically induced menopause, even when the ovaries remain intact.
Researchers now believe that this procedure is very promising for women who want to preserve their fertility but whose symptoms cause significant issues in their lifestyle or are impacting their fertility. The laser treatment is also called myolysis. The concept is to coagulate the blood supply to the fibroids using the laser which will cause them to lose blood supply, shrink and die.
Uterine fibroids are “fed” by estrogen levels in a woman’s body. This means that as she approaches menopause the size of the fibroid naturally decreases as the level of estrogen in the bloodstream also naturally decreases. The natural history of development and death of uterine fibroids may give women greater options to choose from if they are closer to menopause age than if they are younger.
Women who have four or more fibroids which measure 5 cm or more are not candidates for the laser treatment. An 8 cm fibroid will take approximately 30 minutes to treat. Most physicians will give drugs for three to six months prior to the planned procedure in an attempt to medically shrink the fibroids. While this pharmaceutical option is successful in the short term it is not a long-term option for women because the drugs used often leaches calcium out of the bones and cause premature osteoporosis. If the uterine fibroids do not shrink by approximately 30% using the drug therapy then the surgeon will not attempt a myolysis.
Laser treatment for uterine fibroids is a new option for women that may be able to maintain fertility for some and will keep the uterus intact for all. Any woman who has uterine fibroids should discuss all of her options with her surgeon before making a decision that will affect the rest of her life. Women should only speak with surgeons who are willing to give them all of the options available and discuss them openly and honestly so that she is able to make an informed decision.
(1) London School of Hygiene & Tropical Medicine: Clinical outcomes following percutaneous magnetic resonance image guided laser ablation of symptomatic uterine fibroids
http://researchonline.lshtm.ac.uk/16941/
RESOURCES
Human Reproduction: Clinical outcomes following percutaneous magnetic resonance image guided laser ablation of symptomatic uterine fibroids
http://humrep.oxfordjournals.org/content/17/10/2737.short
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