A Clinical Practice Review, published in the April 23 issue of the New England Journal of Medicine recommends focused ultrasound as an important uterine-conserving treatment that should be an option for women with symptomatic uterine fibroids. Despite the high prevalence of fibroids, exceeding 80% among black women and nearly 70% of white women, there are few randomized trials to guide treatment decisions. Concern has been raised regarding overuse of hysterectomies, accounting for nearly three quarters of all fibroid procedures, and the review discusses several alternatives for women who want to retain their uterus and do not want to undergo the potential complications and recovery time associated with surgery. The recommendations include an algorithm for managing fibroids with focused ultrasound as a treatment option for women even if they do not plan to bear children.
Focused ultrasound is a completely non-invasive FDA-approved treatment for fibroids, which uses high intensity sound waves to heat and destroy the fibroid while leaving the surrounding uterine tissue intact. It is an outpatient procedure that involves no incisions and enables many women to return to normal activity in one or two days. The first focused ultrasound system was approved in the US in 2004, and the treatment has been successfully performed on more than 12,000 women with fibroids worldwide. A news report about the recommendations may be read here.
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