Potential of minimally invasive procedures in the treatment of uterine fibroids: a focus on magnetic resonance-guided focused ultrasound therapy

Fischer, Krisztina; McDannold, Nathan; Tempany, Clare M.; Jólesz, Ferenc A.; Fennessy, Fiona M.

doi:10.2147/ijwh.s55564

Cited by 12 publications

(8 citation statements)

References 113 publications

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“…Ultrasonic energy is directed to a point inside the fibroid and coagulation tissue necrosis is induced in the myoma. In theory, damage to surrounding tissue is minimal ( Clark et al ., 2014 ; Park et al ., 2014 ) but, in fact, the impact on critical neighboring structures cannot be excluded ( Fischer et al ., 2015 ; Kim et al ., 2015 ).…”

Section: Alternatives To Surgical Interventionmentioning

confidence: 99%

Uterine fibroid management: from the present to the future

Donnez

Dolmans

2016

Hum. Reprod. Update

556

506

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Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Clinical presentations include abnormal bleeding, pelvic masses, pelvic pain, infertility, bulk symptoms and obstetric complications.Almost a third of women with leiomyomas will request treatment due to symptoms. Current management strategies mainly involve surgical interventions, but the choice of treatment is guided by patient's age and desire to preserve fertility or avoid ‘radical’ surgery such as hysterectomy. The management of uterine fibroids also depends on the number, size and location of the fibroids. Other surgical and non-surgical approaches include myomectomy by hysteroscopy, myomectomy by laparotomy or laparoscopy, uterine artery embolization and interventions performed under radiologic or ultrasound guidance to induce thermal ablation of the uterine fibroids.There are only a few randomized trials comparing various therapies for fibroids. Further investigations are required as there is a lack of concrete evidence of effectiveness and areas of uncertainty surrounding correct management according to symptoms. The economic impact of uterine fibroid management is significant and it is imperative that new treatments be developed to provide alternatives to surgical intervention.There is growing evidence of the crucial role of progesterone pathways in the pathophysiology of uterine fibroids due to the use of selective progesterone receptor modulators (SPRMs) such as ulipristal acetate (UPA). The efficacy of long-term intermittent use of UPA was recently demonstrated by randomized controlled studies.The need for alternatives to surgical intervention is very real, especially for women seeking to preserve their fertility. These options now exist, with SPRMs which are proven to treat fibroid symptoms effectively. Gynecologists now have new tools in their armamentarium, opening up novel strategies for the management of uterine fibroids.

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Section: Alternatives To Surgical Interventionmentioning

confidence: 99%

Uterine fibroid management: from the present to the future

Donnez

Dolmans

2016

Hum. Reprod. Update

556

506

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“…However, if a woman has serious pain or other symptoms, several therapy options can be used to treat the symptoms. Gonadotropin-releasing hormone agonists and synthetic steroids with antiprogesterone activity, such as mifepristone, slow or stop the growth of fibroids 8. Surgical therapy or uterine artery embolisation can also be considered 7…”

Section: Discussionmentioning

confidence: 99%

Gyejibongneyong-hwan, a herbal medicine for the treatment of dysmenorrhoea with uterine fibroids: a protocol for a randomised controlled trial

Jung

Lee

et al. 2016

BMJ Open

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IntroductionGyejibongneyong-hwan (GBH), or the Guizhi Fuling Formula in Chinese, is widely used to treat uterine fibroids in East Asian countries including Korea, China and Japan. This study will assess the efficacy and safety of the GBH formula for the treatment of dysmenorrhoea.Methods and analysisThis study will be a randomised double-blind controlled trial with two parallel arms: the GBH group and the placebo group. This trial will recruit 38 women between 18 and 45 years of age with secondary dysmenorrhoea with uterine fibroids. The investigational drugs, either GBH or placebo, will be administered to the participants three times per day for two menstrual periods (8 weeks). The participants will be followed up for three menstrual cycles after administration of the drugs. The primary outcome will be the Numeric Rating Scale score of average menstrual pain. All analyses will be performed with SAS (V.9.1.3; SAS Institute, Cary, North Carolina, USA) by a statistician blinded to the allocation of the groups. Statistical analysis will be undertaken on the intent-to-treat (ITT) basis with a 95% CI using the last observation carried forward for missing values. The ITT analysis will include all randomised patients.Ethics and disseminationThis research protocol has been reviewed and approved by the institutional review boards of the trial centre (number WSOH IRB 1606-03). Written informed consent will be obtained from all study participants prior to enrolment in the study. The results will be published in a peer-reviewed journal and will be disseminated electronically and in print.Trial registration numberKCT0001967.

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“…Minimally invasive procedures to treat a variety of cancerous and noncancerous diseases, such as unresectable hepatocellular carcinoma [ 1 ], benign prostatic hyperplasia [ 2 ], uterine fibroids [ 3 ], and acute hemorrhage [ 4 ], have gained much attention in the clinic. Particularly, trans -catheter arterial embolization (TAE) is generally considered safe and effective in interventional therapy, which selectively delivers the embolic agents to the target artery under X–ray guidance.…”

Section: Introductionmentioning

confidence: 99%

Immobilized thrombin on X-ray radiopaque polyvinyl alcohol/chitosan embolic microspheres for precise localization and topical blood coagulation

Chen

et al. 2021

Bioactive Materials

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Potential of minimally invasive procedures in the treatment of uterine fibroids: a focus on magnetic resonance-guided focused ultrasound therapy

Cited by 12 publications

References 113 publications

Uterine fibroid management: from the present to the future

Uterine fibroid management: from the present to the future

Gyejibongneyong-hwan, a herbal medicine for the treatment of dysmenorrhoea with uterine fibroids: a protocol for a randomised controlled trial

Immobilized thrombin on X-ray radiopaque polyvinyl alcohol/chitosan embolic microspheres for precise localization and topical blood coagulation

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