Uterine Fibroids and Hysterectomy - Other Procedures

Myolysis (Laparoscopic Leiomyoma Coagulation)

Myolysis, or laparoscopic leiomyoma coagulation, uses either lasers or electrosurgery to heat and coagulate and destroy the fibroid tissue. This approach may prove to be beneficial for women with fibroids that measure a diameter of 10 cm (about 4 in.) or less and that respond to hormone treatments with GnRH agonists.

Myolysis employs a needle or a Nd:YAG laser that rapidly punctures a number of holes in the fibroid, heating and destroying the tissue in various locations. This widespread destruction cuts off the blood supply and shrinks the fibroid over ensuing months. The uterus is left intact, but tissue destruction makes childbearing unlikely.

In one study, myolysis performed either alone or with endometrial resection was successful in avoiding the need for major surgery in 97% of women. Advanced techniques that are performed by surgeons who are highly skilled in the procedure may make it possible to destroy even large intramural fibroids, but further study is required.

In most cases, patients return home the same day and can return to normal activities within a week. There are few side effects. However, as the fibroids degenerate over time, many women report considerable pain.

Investigative Approaches

Some researchers are studying high-intensity focused ultrasound guided by magnetic resonance imaging (MRI) to heat and destroy uterine fibroids. Encouraging trials using this procedure have been conducted, but more research is necessary to demonstrate the safety and efficacy of the technique.

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