Nonsurgical Alternatives for Uterine Fibroids

• Published in: Best practice & research. Clinical obstetrics & gynaecology 2016-07, Vol.34, p.122-131
• Main Authors: Zupi, Errico, MD, Centini, Gabriele, MD, Sabbioni, Lorenzo, MD, Lazzeri, Lucia, MD, PhD, Argay, István Máté, MD, Petraglia, Felice, MD
• Format: Article
• Language: English
• Subjects: cryomyolysis; Cryosurgery; Female; fibroids; High-Intensity Focused Ultrasound Ablation; Humans; Leiomyoma - diagnostic imaging; Leiomyoma - surgery; Leiomyoma - therapy; Magnetic Resonance Imaging; MRgFUS; nonsurgical; Obstetrics and Gynecology; Therapy, Computer-Assisted; UAE; Uterine Artery Embolization; Uterine Neoplasms - diagnostic imaging; Uterine Neoplasms - surgery; Uterine Neoplasms - therapy
• ISSN: 1521-6934; 1532-1932
• DOI: 10.1016/j.bpobgyn.2015.11.013

Uterine leiomyomata are the direct cause of a significant health-care burden for women, their families, and society as a whole. Because of the long experience with the mode of treatment, surgical myomectomy remains the gold standard for treating reproductive-age women; however, in the recent years, the wide evolution of less invasive approaches led to a change in the options used by the clinician to treat symptomatic fibroids. Minimally invasive procedures such as uterine artery embolization (UAE) are increasingly used to treat symptomatic fibroids. Other alternative treatments are becoming more diffuse, such as magnetic resonance–guided high-frequency focused ultrasound surgery (MRgFUS), cryomyolysis, vaginal occlusion, and laparoscopic closure of the uterine arteries. Both advantages and limitations of these techniques under development must be taken into account, but this wider range of choices is being increasingly considered for a tailored treatment. This article aims to enable health-care providers with the tools to provide the latest evidence-based care in the minimally invasive or noninvasive management of this common problem.