Fixing fibroids

2 new treatments that don't require major surgery


SAN FRANCISCO, Calif – Pilates studio owner Tonya Amos needs her body to run her business. However, the former professional dancer started feeling intense pain. A visit to her doctor revealed the cause.

"She said, ‘Does this hurt?' and she pushed on my abdomen, and I said, ‘Yeah that hurts', and she said, ‘Yeah that's a fibroid,'" Amos explained.

Amos had several fibroids. One of them was as large as a grapefruit.

"What I heard over and over was ‘you need a hysterectomy,'" Amos said. "That was not an option for me."

Dr. Vanessa Jacoby, MD, MAS, Assistant Professor Obstetrician/Gynecologist, Dept. of Obstetrics, Gynecology, and Reproductive Services, University of California, San Francisco, is studying new ways to shrink fibroids, without major surgery. With MR-guided focused ultrasound, an ultrasound beam focuses on the fibroid and creates heat.

"That heat burns the fibroid cells and destroys them," Jacoby said.

Another method, laparoscopic radiofrequency ablation, requires three tiny incisions. A probe is placed in the fibroid.

"We use radiofrequency energy to burn the fibroid cells," Jacoby explained.

With a hysterectomy, there's a three- to six-week recovery. The ablation is about a week. The ultrasound therapy is just two days.

Amos had the ultrasound treatment. It shrunk her fibroids.

"It feels like my body again," Amos said. "I got my body back!"

Jacoby says not all patients with fibroids are candidates for these two new treatments. It depends on the size, location, and number of fibroids.

Additional Information:

Uterine fibroids are benign tumors made up of muscle cells and other tissue that grow within the wall of the uterus. The tumors can vary in size and number and are more common in African American women. Fibroids are the most common type of uterine tumor affecting 25 percent of childbearing women. Some estimates say up to 75 percent of women will have a fibroid at some point in their life. Signs and symptoms of fibroids include heavy or abnormal bleeding, pain, pelvic cramping or pressure and bloating. Uterine fibroids have been associated with infertility, miscarriage and early onset of labor. (www.mayoclinic.com)

TYPES: There are three different types of uterine fibroids that can occur:

  • Inramural: The most common type of fibroid. They are found in the wall of the uterus and cause heavier than normal menstrual bleeding, pelvic pain, back pain or generalized pressure.
  • Submucosal: This is the least common type of fibroid, but often times the most problematic. Submucosal fibroids are found in the muscle beneath the inner lining of the uterus.
  • Subserosal: These fibroids grow on the outside of the uterus' wall and can become very large. They typically don't affect menstrual cycle, but then can cause significant pelvic and back pain as well as generalized pressure. (Source: www.womenshealth.gov)

NEW TECHNOLOGY: There are now two new ways to treat fibroids, so patients don't have to choose between a hysterectomy and a myomectomy. One of the treatments is called MR-guided focused ultrasound. Using an MRI machine, an ultrasound beam is focused on the fibroid. The high heat kills the fibroid cells, and will slowly shrink it over a period of a few months. The other technique is called laparoscopic radiofrequency ablation. Doctors cut two tiny incisions in the abdomen and insert an ablation tool. Again using an MRI, the doctors determine where the ablation needs to take place, then use radiofrequencies to destroy the fibroid cells. It's generally an out-patient procedure, and patients go home the same day. Recovery time is usually about a week. (Source: Dr. Vanessa Jacoby)