Uterine Fibroids and Hysterectomy - Medications

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Highlights	Diagnosis	Resources
Introduction	Treatment	References
Risk Factors	Medications	Resources
Complications	Surgical Alternatives to Hysterectomy	References
Symptoms	Hysterectomy

Endometrial ablation significantly decreases the likelihood a woman will become pregnant. However, pregnancy can still occur and this procedure increases the risks of complications, including miscarriage. Women who have this procedure must be committed to not becoming pregnant and to using birth control. A main concern of endometrial ablation is that it may delay or make it more difficult to diagnose uterine cancer in the future. [For more information, see In-Depth Report #100: Menstrual disorders.]

Magnetic Resonance Guided Focused Ultrasound (MRgFUS)

MRgFUS is a non-invasive procedure that uses high-intensity ultrasound waves to heat and destroy (ablate) uterine fibroids. This “thermal ablation” procedure is performed with a device that combines magnetic resonance imaging (MRI) with ultrasound. The Food and Drug Administration approved this device, the ExAblate 2000 System, in 2004.

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During the 3-hour procedure, the patient lies inside an MRI machine. The patient receives a mild sedative to help relax but remains conscious throughout the procedure. The radiologist uses the MRI to target the fibroid tissue and direct the ultrasound beam. The MRI also helps the radiologist monitor the temperature generated by the ultrasound.

MRgFUS is appropriate only for women who have completed childbearing or who do not intend to become pregnant. The procedure cannot treat all types of fibroids. Fibroids that are located near the bowel and bladder, or outside of the imaging area, cannot be treated.

This procedure is new and long-term results are not yet available. Likewise, it requires an extensive period of time involving MRI equipment. Many insurance companies do not pay for this treatment.

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Review Date: 07/26/2010
Reviewed By: Reviewed by Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).