Uterine fibroids (also referred to as myomas, leiomyomas, leiomyomata, and fibromyomas) are benign (non-cancerous) tumors that grow within the muscle tissue of the uterus.  They are the most common pelvic tumors in women, with a prevalence of 20-40% in women of reproductive age. Fibroids occur at a higher rate among women of African-American descent.  While many women with fibroids do not experience any symptoms, the location and size of fibroids can change and cause symptoms that can affect a woman’s quality of life.

ExAblate using MR guided focused ultrasound for treating uterine fibroids
ExAblate 2000 is the only FDA approved non-invasive surgical system to use sound waves instead of a scalpel to remove uterine fibroids.

Magnetic Resonance guided Focused Ultrasound (MRgFUS) has been demonstrated as a viable option for effectively treating uterine fibroids. Compared to traditional hysterectomy, which is the primary treatment option for uterine fibroids, MRgFUS offers both clinical and economic advantages. Because it is a non-invasive procedure, patients avoid the risks associated with surgery, require only limited conscious sedation, and can return to normal activities the next day compared to lengthy recovery times and hospitalization days for the more traditional hysterectomy surgery. This translates into a significant economic impact for patients who undergo the MRgFUS procedure with documented fewer disability days (decreased days of missed work or days in bed) and lower use of medical resources: 83% fewer physician visits, 66% fewer additional diagnostic tests, and 66% fewer additional procedures.

  
Click here to view an animation of how MR guided focused utlrasound treats uterine fibroids.

Uterine Fibroids treatment comparison


In side by side studies conducted by InSightec, women treated with ExAblate were able to return to work and normal life much more quickly, reducing the burden on the healthcare system and their families. Women treated with ExAblate missed 1.4 working days, compared to 18 days for women with hysterectomies; they returned to normal activities in less than three days, compared to 17 days; and they had 66% fewer doctor visits and additional procedures than women treated with hysterectomy,. Adverse effects, while rare, included minor skin burns and a few instances of nerve injure, all of which resolved within one year.  See below uterine fibroids case that had ExAblate treatment.

Uterine Fibroids case
40 year old patient with 526cc fibroid and prolonged heavy bleeding.

         
T2 image before treatment         T1 contrast enhanced image           T1 contrast enhanced image
                                                one month after treatment               36 months after treatment

Outcome: marked reduction in all symptoms. Fibroid reduced to 455 cc after one month and 298cc after 36 months.

Courtesy of Sheba Medical Center, Tel Aviv, Israel

For more information, click here to visit our patient website.

Uterine fibroids are also classified according to their location.  There are three primary types of fibroids, although many fibroids cannot be purely classified into one of these categories:     

Subserosal: These fibroids develop in the outer portion of the uterus and continue to grow outward.

Intramural: The most common type of fibroid.  These develop within the uterine wall and expand making the uterus feel larger than normal (which may cause “bulk symptoms”).

Submucosal: Fibroids that develop just under the lining of the uterine cavity.  These are the fibroids that have the most effect on heavy menstrual bleeding and the ones that can cause problems with infertility and miscarriage.

Pedunculated: Fibroids that grow on a small stalk that connects them to the inner or outer wall of the uterus.

The following may be symptoms of uterine fibroids:

• Very heavy and prolonged monthly periods, sometimes with clots
• Pain in the back or in the legs
• Pelvic pain or pressure
• Pain during sexual intercourse
• Pressure on the bladder which leads to a constant need to urinate, incontinence, or the inability to empty the bladder
• Pressure on the bowel which can lead to constipation and/or bloating
• An enlarged abdomen which may be mistaken for weight gain or pregnancy