The new method, which uses magnetic resonance imaging (MRI) to guide lasers and requires only a local anesthetic, is detailed in the October issue of Human Reproduction.
Although lasers have been used to treat fibroids, the affair was notoriously hit-or-miss, and often caused damage to surrounding tissue, says study author Dr. Wladyslaw Gedroyc, a consultant radiologist and head of the Department of Interventional Magnetic Resonance Imaging at St. Mary's Hospital in London. "Before, you had absolutely no control over what you were doing," Gedroyc says, but MRI lets physicians use lasers with much more precision.
Because lasers are "reasonably accepted" for the destruction of fibroids, the procedure could be in widespread use relatively soon, he says.
Some 25 percent of women suffer from fibroids, which are benign fibrous tumors in the uterus. Some are asymptomatic, but others can cause excessive bleeding and pain, and may result in infertility or miscarriage. When symptoms are problematic, a major recourse has been to remove the uterus with a hysterectomy, a major surgery that many experts feel is excessive.
Less invasive techniques are being developed, but most still require general anesthetic and a hospital stay, the study authors say.
In the new procedure, which has been performed on 66 women between the ages of 34 and 55, the surgeon, using the MRI as a guide, inserts four small needles into the fibroid. Laser fibers inserted into the needles destroy the fibroid with heat. The image turns from blue to green when the temperature reaches the right level, so the doctor knows when to "maximize treatment" in the target area.
The women who had the procedure experienced a mean reduction in fibroid volume of 31 percent after three months, with the range being 13 percent to 78 percent. The 24 women who received one-year follow-up MRI scans had a mean reduction of 41 percent. All but one of the patients had the procedure done on an outpatient basis.
A minority of the women in the study were surveyed for blood loss after the procedure, and all of them reported less blood loss three months later. Of 35 women who completed a survey, 69 percent reported an improvement in symptoms.
Some physicians say the procedure doesn't address the right issues, however.
"They're not addressing the reasons for the condition in the first place," says Dr. Allan Warshowsky, author of Healing Fibroids: A Doctor's Guide to a Natural Cure and director of the Women's Center at the Continuum Center for Health and Healing in New York City.
There are also various limitations, Warshowsky points out, including where the fibroid is located and how large the woman is. "They can't do this through the abdomen in fibroids that are way posterior," Warshowsky says. "Accessibility is probably also related to the woman's abdominal girth."
Because estrogen tends to fuel fibroids, and because fat increases estrogen production, overweight women tend to be particularly prone to fibroids.
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