Authors: Quinn, S, Vedelago J, Gedroyc W, Regan L.
Journal: Europeam Journal of Obstetrics & Gynecology and Reproductive Biology
Study From: London, England
Problem: While MRgFUS (also called high intensity focused ultrasound or HIFU) is not new, the results of treatment over the long-term have not been reported in the medical literature.
Study: Following treatment with MRgFUS (HIFU), 280 women were evaluated for complications from the treatment. Five years after treatment, 162 of those women were evaluated to determine if another treatment had been needed to resolve fibroid symptoms.
Results: Three women had serious complications (1.1%) including one woman with a skin burn that required surgical repair, one woman with a fibroid that passed through the vagina following treatment and one woman with a persistent nerve injury. Of the 162 women who had 5 years of follow-up, 59% needed another type of treatment to give them symptom relief. When more than half of the fibroid volume was able to be treated, 50% of women needed an additional treatment to deal with their symptoms.
Authors’ Conclusions: MRgFUS (HIFU) treatment of uterine fibroids is a safe treatment for uterine fibroids. The re-intervention rate at 5 years is high, but improvements in technique may further improve the long-term results.
Dr. Parker’s Comments:
High intensity focused ultrasound seems like an ideal treatment for fibroids; for most women it is painless, treatment requires no anesthesia and the recovery requires essentially no time off from work or family. However, the results of treatment have been disappointing. Early on, when the technology was new, the FDA only allowed small areas of the fibroids to be treated to make sure the technique was safe. Therefore, the symptom relief was understandably limited. More recent studies have treated more of the fibroid volume with seemingly better results.
But, even new MRgFUS (HIFU) techniques are not able to treat the entire fibroid volume raising the question: is this good enough? This study suggests that while MRgFUS (HIFU) appears to be safe, many women need other treatment to deal with persistent fibroid symptoms. Although I am rooting for this technique because of its non-invasive approach and quick recovery, I think it is still not effective enough for the majority of women with fibroids.
