Focused Ultrasound and Myolysis

These are relatively new treatments that are only available in a few centres. However, Focused Ultrasound is being offered by more hospitals.

Magnetic Resonance Guided Focused Ultrasound

Magnetic resonance is used to guide ultrasound to the middle of the fibroid. The ultrasound is delivered through the skin starting with low power and when the centre of the fibroid is targeted high power ultrasound is delivered to destroy the fibroid. This is not suitable for large fibroids.

Here are the NICE guidelines on MRI-guided focused ultrasound for fibroids. They state - "Current evidence on the safety and efficacy of magnetic resonance image (MRI)-guided transcutaneous focused ultrasound for uterine fibroids is such that this procedure should only be used with special arrangements for consent and for audit or research." These are to be updated in spring 2011.

Myolysis

A laser is used to coagulate the blood vessels feeding the fibroid. The laser is normally inserted via a laparoscope. The fibroids do not always shrink and hysterectomy is sometimes needed.

This treatment must not be used on women wishing to have children. There have been a number of reports of rupture of the uterus/womb in pregnancy after this treatment. In some cases the uterine rupture has resulted in the death of the baby.

Further information on myolysis and focused ultrasound can be found in these pages from Capital Doctor, which followed up the February 2004 article that is featured elsewhere, and information from St. Mary's Hospital, Paddington, the UK centre for this procedure.

Read our FUS and Myolysis FAQs