According to accepted statistics, about one in five women older than 30 years of age suffer from myomoneous formations in the uterus.
Often, myomatous nodes are treated by surgical removal, which is considered the fastest method of treating myomas.
But doctors still try to avoid surgical manipulations and resort to them only in extreme situations. Usually, specialists choose conservative ways of solving the problem, which help stop growth and reduce tumor parameters.
What is FUS Ablation?
One of the most common non-invasive ways to get rid of myomas nodes is FUS ablation.
Most often, myomas have a multiple nature, but not all nodes are determined by palpation. Therefore, with a gynecological examination, the doctor may simply not notice the development of the myomatous process.
As a result, the disease gradually progresses and is revealed when the patient grows several large myomatous formations. To get rid of such a fibroid, you can only surgically remove it.
But surgical interventions are accompanied by specific risks and fraught with various complications such as adhesions, sepsis, hernial processes, etc. But thanks to FUS ablation these complications can be avoided, and this removal is carried out minimally invasively under the control of MRI equipment.
Advantages of
In comparison with other methods of treatment of myomatous processes in the uterus, FUS ablation has several advantages:
- During the procedure, there is no need for cuts of the abdominal wall;
- The procedure is carried out under constant monitoring with the help of a magnetic resonance tomograph in which the patient is placed;
- On the uterine body, after evaporation, no stitches remain, which eliminates the risk of complicating pregnancy in the future;
- FUS ablation is well tolerated;
- Procedure does not have blood loss;
- Such treatment does not require anesthesia, because the procedure does not cause pain. This nuance is very important for patients who are intolerant to anesthesia. But if there is a need( low pain threshold, fear, panic, etc.), then the doctor will do local anesthesia;
- During the evaporation process, the effect can be carried out simultaneously on several myomas nodes;
- The procedure virtually eliminates the possibility of myomatous relapse;
- The patient remains conscious throughout the procedure and informs the specialist of the sensations experienced. If there is a particular discomfort, the patient can warn the doctor and, if necessary, the procedure will be terminated.
A few hours after FUS ablation, the woman is released home, because such a technique does not have extensive wound surfaces and does not require long-term rehabilitation. The doctor himself will appoint, after what time the woman will need to come to the control examination.
Contraindications
Even such a "miraculous" procedure as FUS ablation has specific contraindications, therefore it may not be performed for all patients.
A similar method of treating myomatous formations does not apply:
- If myomoral formation grows on the stalk;
- If there are more than 5 knots;
- With too large a tumor area;
- If the myoma is of an intramural nature( it forms deeply);
- The weight of the patient is more than 110 kg and the waist circumference is more than 110 cm;
- In the presence of an adhesive process in the low-dose region;
- Presence of abdominoplasty in anamnesis, cardiovascular problems;
- If an intrauterine device is installed, a pacemaker, implants of metal or magnets;
- In the presence of claustrophobia or panic attacks;
- In pregnancy;
- With small myomas nodes( less than 1.5 cm).
Preparation of
As with normal surgical procedures, a woman undergoes preoperative preparation.
The patient is referred for a thorough examination to determine the location, nature, size and number of nodes.
The doctor necessarily determines the distance from the tumor to the sacrum, since when the myoma is located too close to it( closer than 4 cm), the risk of damage to the sciatic nerves during the ultrasonic effect is great.
If the tumor is located in the depth of the abdominal cavity more than 10 cm or there are more than 5 nodes, then the FUS ablation is not performed. In addition, such a technique is not suitable for treating too large myomic formations more than 500 cm³.
The patient before surgery gets rid of pubic and abdominal hair to avoid burn damage to the peritoneum. Mandatory traditional laboratory studies and hardware diagnostics are carried out.
How does the procedure work?
FUS ablation follows the following algorithm:
- Ultrasonic waves are sent by pulses to the area of the myoma. Impulses pass through tissue structures without damaging them. These waves warm up a specific tumor fragment, which leads to thermal necrosis of the tissues. Usually the thermal effect is of the order of half a minute;
- After thermal exposure by ultrasonic waves, the treated area is scanned by a tomograph, the specialist sees a three-dimensional image and visually sees the site of the effect;
- After heating, cooling is carried out for about a minute.
Sometimes patients describe that there is a feeling of warmth in the area of the uterus, as well as a pulling feeling that resembles menstruation. With severe pain and other severe discomfort, the patient can press a special button, then the evaporation procedure will stop.
Side effects of
Although FUS ablation is one of the unique methods of treating myomatous tumors, the procedure may also be accompanied by side effects:
- If the procedure is performed by an unskilled or inexperienced doctor, there is a risk of burn injuries;
- There is a possibility of recurrence of evaporated myomatous formation;
- There are no exact data on the effects of FUS ablation on conception and further pregnancy. It is not known how the ultrasound treatment of the uterus will affect the further reproductive capabilities of the patient;
- In case of damage to the sciatic nerve, the patient develops neurological complications.
Recovery of
In the recovery period, patients after FUS ablation usually do not need. Already the next day the patient is taken home, she can do the usual thing or go back to work.
In some cases, ultrasonic evaporation of myomatous formations is performed on an outpatient basis. Already after the procedure, gradual destruction of the treated nodes begins.
Approximately six months later the patient comes to a specialist for a follow-up examination.
Practice shows that a significant majority of patients after evaporation had a multiple reduction in nodes, and some even completely resolved.
Where and by whom?
Similar procedure is carried out in many modern clinics, however, because of its high cost, not every patient can afford such treatment for fibroids.
Compared with arterial embolization of the uterus, ablation is available in most private medical centers, while EMA is conducted only in the largest and mostly private medical institutions.
Reviews about FUS ablation of myoma of the uterus
Patients actively leave feedback about this procedure, because it is still relatively young, and raises more questions than answers.
In the opinion of specialists, FUS ablation is considered the most optimal way for treating modern miomics in modern women. After all, laparotomy is not suitable for every patient, and after a lumbar operation, long-term rehabilitation is necessary.
Olesya:
I am 42, have found multiple myoma, 4 large nodes. The doctor said that the uterus will have to be removed, especially since there are already two children. And I'm not going to give birth to the third. At first, I was very upset, but then one familiar doctor told me about the ultrasound evaporation of myomas. How glad I am that I did not go for a hysterectomy. After FUS ablation, fibroids have greatly decreased. Two are not seen at all, one decreased to 7 mm( three times), the other to 6 mm.
Inga:
During the next medical examination it was found out that in my uterus myoma 5 cm, hemoglobin pathologically low, during the monthly from me so poured that it became scary. We decided with the doctor that it is better to do FUS ablation. It's amazing, but the procedure took only a few hours, and in the evening I was already at home. In half a year at control examination myoma was not found out.
Larissa:
When my myoma was found, I was looking for information about the ways of its treatment for a long time. Very interested in the method of FUS ablation. We do not do such operations in the district multidisciplinary medical center, so I went to Moscow. Coordinates of a suitable clinic took from a friend of the doctor. In the morning I went to the clinic, immediately took tests and already at lunch I was prepared for the procedure. They put it inside the MRI unit and started to influence the nodes with ultrasound. I felt some warmth and a little pull of the lower abdomen, like before the menstrual period. But otherwise everything went fine. I lay on the procedure for three hours, and in the evening I was going back home. Now I do not remember about myoma. The treatment was successful.
Price
The average price of FUS ablation of uterine fibroids is about 46-117 000 ₽.The final cost depends on the degree of damage to the uterus, the treatment area, the status of the clinic and the doctor conducting the procedure.
Video about FUS ablation of uterine fibroids: