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Less invasive fibroid treatments look promising. (Two Pilot Trials).
LOS ANGELES -- Two new directions in fibroid surgery-radiofrequency ablation and Mm-directed cryotherapy--performed well enough in pilot trials to warrant further study investigators reported at the annual meeting of the American College of Obstetricians and Gynecologists.
In radiofrequency ablation, a thin needle electrode inserted into a fibroid under ultrasound guidance conducts an alternating current of 400-500 kHz, causing rapid oscillation of intracellular ions in adjacent tissue. The resulting heat kills the fibroid cells, and the tumor necroses. Radiofrequency ablation, which is performed under general anesthesia, has been approved in the United States for ablation of soft tissue and treatment of unresectable liver lesions.
In a retrospective study of 58 patients with a total of 218 fibroids, radiofrequency ablation resolved symptoms at 12 months in 82%-100% of cases of menorrhagia, dysmenorrhea, dyspareunia, pelvic pain, or urinary frequency Dr. Bruce B. Lee of Monterey Calif., said. Dr. Lee owns stock in Rita Medical Systems, Mountain View, Calif., which makes the radiofrequency device.
In patients with uterine volumes of at least 10 weeks' gestation, radiofrequency ablation of fibroids reduced uterine volumes by a mean of 46% after 9 months. Patients had an average of four fibroids each and were followed for an average of 11 months.
The outpatient procedure caused mild to moderate pain that was managed with oral analgesics; some patients did not require any postoperative pain medication, Dr. Lee said.
Patients returned to work in 3-14 days and had resumed normal levels of most activities at the 12-month follow-up.
In a subset analysis of 41 patients who were not taking hormone replacement therapy and did not have endometriosis, all symptoms were resolved at 12 months except menorrhagia, which resolved in 92% of the women. Patients returned to normal levels in all activities except sleep, which reached a normal level in 92% of cases at 12 months.
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Source: HighBeam Research, Less invasive fibroid treatments look promising. (Two Pilot Trials).