Easier Fibroid Surgery

Laser Procedure Uses Local Anesthetic, No Need for Hospital Stay

From the WebMD Archives

Sept. 26, 2002 -- Getting rid of uterine fibroids just got easier. With only a local anesthetic, a laser can zap them away -- and you go home the same day.

A group of British researchers has developed this novel method for treating fibroids. Many women develop the benign, fibrous uterine tumors, which can cause severe bleeding, pain, infertility, and miscarriage. In the U.S., about 400,000 hysterectomies are performed annually for fibroids.

Doctors use a number of techniques to remove fibroids, but all typically involve general anesthesia and a hospital stay. In this new procedure, a laser is guided by magnetic resonance imaging (MRI), under a local anesthetic, says lead author J. T. Hindley, MD, a professor of obstetrics and gynecology at Imperial College School of Medicine in London.

His study appears in this week's issue of the journal Human Reproduction.

In the procedure, four fine needles are inserted through the skin. These are placed into the fibroid -- guided by MRI, which produces a thermal image of the fibroid updated every 3 seconds.

Laser fibers are then inserted into the needles and used to zap the fibroid with thermal energy. The MRI image turns from blue to green as the temperature reaches the optimum level. The "real time" color images allow the doctor to maximize the treatment within the target area -- avoiding damage to normal surrounding tissue.

Thus far, 66 patients aged 34-55 have had the procedure, report the researchers, who are with St. Mary's Hospital in London and the London School of Hygiene and Tropical Medicine.

Three months after the procedure, 47 of the women had follow-up MRIs that showed an average decrease in fibroid size of 31%.One year after the procedure, follow-up MRIs in 24 patients showed a decrease in fibroid size of 41%.

Only one of the patients remained in the hospital overnight, because she lived alone. All were given painkillers to take home. Three needed antibiotics for urinary tract infections and two had minor skin burns, but these did not need additional treatment.

All the women experienced lighter, shorter periods following laser surgery. Those with the worst blood loss beforehand benefited most from the treatment.

Of the 35 who responded to a questionnaire, 69% reported an improvement in symptoms and that they felt better since their treatment; 80% said they would recommend it to a friend. They rated their quality-of-life improvement similar to the control group of women who had a hysterectomy.

The new treatment has special potential for women who wish to preserve their fertility, say researchers. -->

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