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Uterine fibroids

Focused ultrasound is a safe and noninvasive strategy for treating uterine fibroids in certain women, research suggests.

About 20% to 25% of women aged over 30 years have uterine fibroids, which are noncancerous tumours that grow on the wall of the uterus. Women with large fibroids can experience heavy bleeding, pelvic pain and bloating. The standard surgical therapy for uterine fibroids is hysterectomy to remove the uterus. This surgery carries a risk of complications, involves a long recovery and takes away a woman’s capacity to bear children.

A team led by Dr. Elizabeth David, a radiologist at Sunnybrook, conducted a double-blinded, randomized controlled trial to test the effectiveness of MRI-guided high intensity focused ultrasound (HIFU) in relieving fibroid-related symptoms.

With this approach, MRI is used to locate the fibroids, which are then targeted by the ultrasound to burn away the blood vessels feeding the tumour. The technique is noninvasive, painless and has a much shorter recovery time: patients often return to their normal activities the next day. It also preserves fertility.

While the treatment does not eliminate fibroids, early results from the trial indicate that it shrinks them by 20% to 50%. Further, up to 90% of women receiving the treatment report being symptom-free soon after. The technique was evaluated by Health Quality Ontario as being an effective and cost-saving intervention. The agency is recommending the widespread use of focused ultrasound as a noninvasive option for women with uterine fibroids who want to avoid a hysterectomy.