Uterine Fibroid Tumor Treatment Ablation

In addition to myomectomy and hysterectomy procedures, a number of other fibroid treatment options exist. Each treatment has its own set of advantages and disadvantages. Knowing what options are available to you will help you make an informed treatment decision.

Endometrial Ablation

Endometrial ablation is used to treat heavy uterine bleeding. A hysteroscope (a thin fiberoptic tube) is inserted through the vagina and into the uterus. The uterus is filled with fluid to allow the surgeon a clearer view.

The hysteroscope includes a “roller ball” attachment that uses electricity to destroy the endometrium (the inner lining of the uterus). A wire loop that shaves off the endometrium may also be used. The procedure relieves bleeding, and can be used to destroy small fibroids.

Endometrial Ablation Risks

Like any surgical procedure, endometrial ablation carries with it the chance of infection and organ damage. Damage to the uterus or the cervix is possible. After surgery, nausea, vomiting and vaginal discharge are common. Discharge may continue for up to six weeks. Some studies suggest that after ten years women will begin to experience bleeding again, although in reduced amounts. In rare cases, women may experience fluid overload during the operation-the absorption of large volumes of liquid-a serious and potentially fatal condition.

Ablation is an option only for women who no longer wish to bear children. In rare cases it is possible to conceive after the procedure, but the destruction of the endometrium means that any pregnancy would be extremely high risk.

Undiagnosed adenomyosis can complicate endometrial ablation. Adenomyosis occurs when the uterine wall thickens, and the endometrium grows down into the muscle layer. The condition is often associated with multiple childbirths. If adenomyosis is present, ablation often proves ineffective. The endometrium is too deeply embedded in the uterine walls to be destroyed. The tissue continues to bleed and cause pain after ablation. The bleeding, coupled with scarring caused by ablation, may hinder the detection of malignant growths.

New Forms of Ablation

Newer forms of endometrial ablation do not require the use of a hysteroscope. One procedure inserts a special “balloon” into the uterus. The balloon is filled with liquid, and then the outer surface of the balloon is heated to destroy the endometrium.

Myolysis

Myolysis uses electricity or heat to destroy fibroids. A laparoscope is inserted through an incision in the abdomen, and electricity is delivered to the fibroid. Electrical damage causes the fibroid’s blood vessels to close off, so the growth shrinks and dies. Surgical removal of the dead growth is not required.

A different form of myolysis, cryomyolysis, uses liquid nitrogen to freeze the fibroid. The liquid nitrogen is administered through a cryoscope, which is inserted, like the laparoscope, through an incision in the abdomen.

Therapeutic Ultrasound

Therapeutic ultrasound is being investigated as a possible fibroid treatment. A focused beam of ultrasound is sent through the abdominal skin, and directed at the growth. The therapeutic ultrasound beam generates heat that kills a portion of the fibroid. The procedure is repeated until a significant portion of the fibroid is destroyed.

Therapeutic ultrasound is not effective against large growths. No serious side effects of the procedure have yet to be discovered. Further trials are necessary to determine what effect, if any, the procedure has on fertility.