Interventional Uterine-Sparing Therapies for Leiomyomas: A Commentary on Myolysis
| Autor: | A.G. Vilos, Ally Murji, Catherine Allaire, Basim Abu-Rafea, Sukhbir Singh, Nicholas Leyland, G.A. Vilos, P.Y. Laberge, John Thiel |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Modalities Leiomyoma business.industry medicine.medical_treatment Obstetrics and Gynecology Myoma Cryotherapy medicine.disease Clinical trial Systematic review Informed consent Uterine Neoplasms Medicine High-Intensity Focused Ultrasound Ablation Humans Observational study Female Laparoscopy Radiology business Organ Sparing Treatments |
| Zdroj: | Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC. 42(2) |
| ISSN: | 1701-2163 |
| Popis: | Uterine leiomyomas (myomas, fibroids) are very common in premenopausal women and frequently are associated with abnormal uterine bleeding, bulk effects, and reproductive issues. In women who wish to retain their uterus and/or to enhance or retain fertility, interventional therapies have been introduced, including radiofrequency, laser (chromo), cryotherapy, and magnetic resonance (MR)-guided high-intensity focused ultrasound (MRgHIFU) myolysis. In formulating this commentary, all modalities of myolysis from systematic reviews, randomized controlled clinical trials, and observational studies through December 2018 were reviewed. There are only two treatment modalities available in Canada: the laparoscopic radiofrequency volumetric thermal ablation of fibroids (RFVTA) and MRgHIFU systems. In women who wish to enhance or retain their fertility, the safety and efficacy of radiofrequency and HIFU myolysis have not been clearly established, and these treatments should be offered only after extensive counselling and informed consent. Given the recent concerns regarding the incidence of undiagnosed malignant tumours, the lack of histological confirmation before or after these therapies for symptomatic fibroids mandates a thorough process of informed patient consent before any such interventions. |
| Databáze: | OpenAIRE |
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