HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kunde, D. Articles by Khalaf, Y. Search for Related Content PubMed Articles by Kunde, D. Articles by Khalaf, Y.

Alternatives to hysterectomy for treatment of uterine fibroids

Department of Women's Health, Guy's & St Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK. email: dattakumar.kunde{at}gstt.nhs.uk (corresponding author)

Yakoub Khalaf, MD MRCOG, Consultant Gynaecologist

Guy's & St. Thomas' Hospital, London, SE1 7EH, UK.

In recent years there has been a trend towards conservative treatment for symptomatic uterine fibroids. Historically, myomectomy has been the operation of choice. Over the past few years, however, new minimally invasive procedures have evolved. These include laparoscopic myomectomy, laparoscopic myolysis, uterine artery embolisation and, more recently, magnetic resonance-guided percutaneous laser ablation, interstitial laser photocoagulation and high-intensity focused ultrasound energy. Simultaneously, nonsurgical treatments including gonadotrophin-releasing hormone analogues and a levonorgestrel intrauterine system have been tried, with limited success. In this era of evidence-based medicine, a thorough assessment of available research data is necessary to determine the place of new therapies in clinical practice. This review discusses the various treatments and outlines a pragmatic approach to the management of fibroids in women wishing to preserve their uterus. This should enable clinicians to counsel women regarding the most appropriate treatment option based on the specific clinical situation.

Keywords Keywords / fibroids / GnRH analogues / minimal access surgery / myomectomy / non-surgical treatment / uterine artery embolisation