Women seeking second opinion for symptomatic uterine leiomyoma: role of comprehensive fibroid centerReport as inadecuate




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Journal of Therapeutic Ultrasound

, 2:3

First Online: 15 April 2014Received: 01 November 2013Accepted: 30 January 2014

Abstract

ObjectiveThe objective of the study was to describe our early experience with a comprehensive uterine fibroid center and report our results in women seeking a second opinion for management of symptomatic uterine leiomyoma.

MethodsWe performed a HIPAA-complaint, IRB-approved retrospective study of women seeking second opinion for management of uterine fibroids at our multidisciplinary fibroid treatment center in a tertiary care facility from July 2008 to August 2011.
After a review of patients’ history, physical examination, and magnetic resonance imaging MRI findings, treatment options were discussed which included conservative management, uterine-preserving options, and hysterectomy.
We performed Fisher’s exact test for categorical variables between the cohort that did or did not undergo a uterine-preserving treatment.
Differences were considered significant at p < 0.05.

ResultsThe mean age of the 205 patient study cohort was 43.8 years SD 7.5.
One hundred sixty-two 79.0% patients had no prior therapy.
Based on MRI, one or more fibroids were detected in 178-205 86.8%, adenomyosis in 8-205 3.9%, and a combination of fibroid and nonfibroid condition i.e., adenomyosis, endometrial polyp in 18-205 8.8%.
In those who desired to transition their care to our institution n = 109, 85 patients underwent 90 interventions: 39 MRgFUS magnetic resonance-guided high-intensity focused ultrasound surgery, 14 UAE uterine artery embolization, 25 myomectomies, 8 hysterectomies, 3 polypectomies, and 1 endometrial ablation.
Five patients had two procedures.
Intramural and subserosal fibroids were most commonly treated with MRgFUS followed by myomectomy and then UAE; in contrast, pedunculated fibroids were frequently managed with myomectomy.

ConclusionsMultidisciplinary fibroid evaluation may facilitate the increase use of less invasive options over hysterectomy for symptomatic fibroid treatment.

KeywordsFibroids MRgFUS Fibroid center Multidisciplinary AbbreviationsMRgFUSMR-guided focused ultrasound surgery

MRImagnetic resonance imaging

UAEuterine artery embolization.

Electronic supplementary materialThe online version of this article doi:10.1186-2050-5736-2-3 contains supplementary material, which is available to authorized users.

Nelly Tan, Timothy D McClure, Christopher Tarnay, Michael T Johnson, David SK Lu and Steven S Raman contributed equally to this work.

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Author: Nelly Tan - Timothy D McClure - Christopher Tarnay - Michael T Johnson - David SK Lu - Steven S Raman

Source: https://link.springer.com/



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