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Uterine fibroids does not require a surgical intervention because of new innovative developments.

Leading medical centers in Israel, Germany, and Turkey apply innovative technologies for the uterine myoma treatment. They allow getting rid of the myomatous nodules without surgeries.


Patients with small myomas which do not grow and have clinical appearances, regular of ultrasound examination are enough. When myomatous nodules achieve 3-4 cm sizes and are insidious, hormonal therapy can be assigned.

The optimal methods for treatment of uterine myoma without surgery are embolization of myomatous arteries and FUS-ablation.

Main advantages of these methods:

  • removal of multiple myomatous tumors;
  • do not cause bleeding;
  • do not leave damages and surgical stitches;
  • are conducted without anesthesia;
  • do not require continuous rehabilitation.

FUS-ablation of uterine fibroids

FUS-ablation is an innovative non-invasive method of uterine myoma treatment.

Ultrasonic waves go through the body tissues without damaging them and direct to the tumor. Myoma is heated, and it leads to the necrosis of its tissues. A doctor receives an image of the affected area using MRI and can direct an ultrasound to a particular spot.

One cycle of FUS-ablation takes from 3 to 6 hours.

During a procedure, a patient is inside the MRI apparatus and lays on the belly immovably. Doctors administer small doses of sedatives to make this situation easier for a patient.

A procedure is painless and sometimes accompanied by some discomfort in the lower abdomen (like during menstruation).

When is FUS-ablation contraindicated?

  • myoma develops on the peduncle;
  • intramural myoma is detected (a neoplasm in the muscle layer);
  • there are more than 5 myomatous nodules;
  • a patient’s weight is over 110 kg and waist circumference over 110 cm;
  • the intrauterine device is used;
  • a diameter of nodules is less than 1.5 cm.

Specialists do not perform this procedure if a patient has cardiovascular diseases, panic attacks, claustrophobia, pregnancy.

FUS-ablation method is quite effective for the removal of the uterine fibroids, but has a range of side effects:

  • there is a possibility of tumor recurrence;
  • a patient may get burns of tissues adjacent to myoma;
  • sciatic nerve may be affected.

Embolization of uterine arteries

Indications for the assignment of embolization of uterine arteries in case of uterine fibroids are:

  • the necessity to preserve the childbearing function;
  • diseases of the respiratory and cardiovascular systems, which exclude anesthesia;
  • previous surgeries for removing of myoma were ineffective.

Mechanism of a procedure::

A specialist administers a catheter in a femoral artery through a small incision which makes is a way to myoma. A special substance - blockaders - is administered in the blood flow. It blocks vessels which ‘feed’ a tumor.

Due to embolization, myoma does not receive the necessary nutrients and begins to decrease. After a procedure, an arteriogram is performed. This study allows doctors to make sure that all the vessels nutrition myoma are blocked.

Contraindications for uterine embolization:

  • pregnancy;
  • vascular disease of the small pelvis;
  • low blood coagulability;
  • idiosyncrasy to the constituent substances of the blockers;
  • myoma on the peduncle;
  • presence of oncological diseases;
  • sexual infections.

Hormonal therapy

Hormones for treatment of uterine myoma are less effective than above-mentioned methods.

This therapy allows decreasing a tumor at 30-50% that makes surgery much easier. If this method is applied without the following surgical intervention, after stopping the medication a myoma begins to grow at an accelerated rate.

Name Mechanism Assignment in case of myoma

Gonadotropin-releasing hormone agonists

(in-GnRH)

Oppress the production of gonadotropin and cause medical menopause.

80% of women contributed to the reduction of myomas. This percentage depends on the age of the patients and the initial size of the nodes. Treatment is accompanied by side effects that are connected with menopause.

Progestins

Analog of progesterone. They block the production of estrogen, metabolic processes in the tumor cells are disrupted.

Cause resorption of myoma nodes in only half the cases. Sometimes cay can provoke the myoma growth.

Derivatives of 17-ethynyl-testosterone

Block the work of the receptors of progesterone and androgens in the ovaries.

They are used in very rare cases for treatment of myoma.

Derivatives of 19-norsteroid

Prevent the work of the receptors of estrogens and the hormone of progesterone in the endometrium.

The most commonly prescribed for the treatment of endometriosis, but also used to reduce blood loss and inhibition of fibroid growth.

Such methods are also used:

  • hormone replacement therapy (analogs of female sex hormones allow to correct climacteric disorders);
  • hormonal contraceptives that control profuse menstrual bleeding;
  • intrauterine device (contains hormones that regulate bleeding).