PURPOSE OF REVIEW: Many nonsurgical and minimally invasive therapies for symptomatic uterine fibroids have been introduced. The purpose of this review is to summarize the recent evidence on these techniques, and their effect on fibroid volume, menorrhagia, health related quality of life (HRQOL), fertility and their risk of complications. RECENT FINDINGS: Laparoscopic or hysteroscopic myomectomy and uterine artery embolization (UAE) have been the most widely studied and all show significantly beneficial effects on menorrhagia and HRQOL, with a low incidence of complications. Magnetic resonance-guided high-intensity focused ultrasound (MRgFUS), myolysis/radiofrequency ablation (RFA) and laparoscopic or vaginal occlusion of uterine vessels (L/V-OUA) are newer interventions, with a smaller body of evidence.For women wishing to retain their childbearing possibilities, myomectomy is the best-studied intervention. Hysteroscopic myomectomy is specifically indicated in submucosal fibroids with subsequently beneficial effects on fertility. The use of UAE in fertile women has not been studied extensively, but evidence points toward an increase in adverse pregnancy outcomes after UAE compared with myomectomy. For MRgFUS, myolysis/RFA and L/V-OUA more evidence is needed. SUMMARY: Laparoscopic/hysteroscopic myomectomy and UAE are evidence-based beneficial alternative therapies for symptomatic uterine fibroids. Until more evidence is available, myomectomy stays the option of choice for women who wish to conceive in the future.
PURPOSE OF REVIEW: Many nonsurgical and minimally invasive therapies for symptomatic uterine fibroids have been introduced. The purpose of this review is to summarize the recent evidence on these techniques, and their effect on fibroid volume, menorrhagia, health related quality of life (HRQOL), fertility and their risk of complications. RECENT FINDINGS: Laparoscopic or hysteroscopic myomectomy and uterine artery embolization (UAE) have been the most widely studied and all show significantly beneficial effects on menorrhagia and HRQOL, with a low incidence of complications. Magnetic resonance-guided high-intensity focused ultrasound (MRgFUS), myolysis/radiofrequency ablation (RFA) and laparoscopic or vaginal occlusion of uterine vessels (L/V-OUA) are newer interventions, with a smaller body of evidence.For women wishing to retain their childbearing possibilities, myomectomy is the best-studied intervention. Hysteroscopic myomectomy is specifically indicated in submucosal fibroids with subsequently beneficial effects on fertility. The use of UAE in fertile women has not been studied extensively, but evidence points toward an increase in adverse pregnancy outcomes after UAE compared with myomectomy. For MRgFUS, myolysis/RFA and L/V-OUA more evidence is needed. SUMMARY: Laparoscopic/hysteroscopic myomectomy and UAE are evidence-based beneficial alternative therapies for symptomatic uterine fibroids. Until more evidence is available, myomectomy stays the option of choice for women who wish to conceive in the future.
Authors: Marlijne E Ikink; Robbert J Nijenhuis; Helena M Verkooijen; Marianne J Voogt; Paul J H M Reuwer; Albert J Smeets; Paul N M Lohle; Maurice A A J van den Bosch Journal: Eur Radiol Date: 2014-08-13 Impact factor: 5.315
Authors: Min Ju Park; Hailian Shen; Jason M Spaeth; Jaana H Tolvanen; Courtney Failor; Jennifer F Knudtson; Jessica McLaughlin; Sunil K Halder; Qiwei Yang; Serdar E Bulun; Ayman Al-Hendy; Robert S Schenken; Lauri A Aaltonen; Thomas G Boyer Journal: J Biol Chem Date: 2018-02-13 Impact factor: 5.157
Authors: M W Beckmann; I Juhasz-Böss; D Denschlag; P Gaß; T Dimpfl; P Harter; P Mallmann; S P Renner; S Rimbach; I Runnebaum; M Untch; S Y Brucker; D Wallwiener Journal: Geburtshilfe Frauenheilkd Date: 2015-02 Impact factor: 2.915
Authors: Ana Luz Carrasco-Choque; Yeni Fernandez-de Lara; Ingrid Vivas-Bonilla; Cecilia Romero-Trejo; Antonio R Villa; Ernesto Roldan-Valadez Journal: Eur Radiol Date: 2015-03-26 Impact factor: 5.315
Authors: Marianne A C Verschoor; Marike Lemmers; Malu Z Wekker; Judith A F Huirne; Mariëtte Goddijn; Ben Willem J Mol; Willem M Ankum Journal: Obstet Gynecol Int Date: 2014-11-04