Melting tumors is new option for women with uterine fibroids
ST. LOUIS — Surgeons commonly treat troublesome uterine fibroids by removing the uterus or cutting out the tumors, but with a newly approved device, surgeons can melt them.
Mercy Hospital St. Louis is the first in the Midwest to offer the procedure, which allows for a quicker recovery and reduces the chance the fibroids will return.
The Acessa device, approved by the FDA a year ago, is a probe that is inserted through a tiny incision. Radiofrequency energy then searches out the tumors and destroys them. The surrounding tissue is left intact, and patients leave the hospital the same day.
"This is the fibroid treatment patients and physicians have been waiting for," said Dr. David Levine, a Mercy obstetrician who participated in the nationwide clinical trial of the device, which involved nearly 240 patients. "It will change the way women think about fibroid removal since they often live with symptoms rather than have major surgery."
By age 50, nearly 80 percent of U.S. women have uterine fibroids, non-cancerous tumors that grow in the walls of the uterus or womb. Symptoms vary widely from no symptoms to extremely heavy bleeding, pelvic pain, constipation and nausea.
Levine says many women suffer with symptoms because they do not want to have a hysterectomy, which can have long-term effects on a woman's health, longevity and sexuality. Recovery takes four to six weeks.
Surgically removing the tumors while leaving the uterus intact also requires at least a two-week recovery, depending on the size of the surgical incision. Also, tumors and symptoms often return.
Levine says the Acessa probe is ultrasound-guided, which allows surgeons to locate all the tumors, some as small as 2mm.
"As a result, we are able to treat all the fibroids, so the recurrence rate will be less," Levine said. "Currently, 35 percent of women will have a recurrence after five years."
Elvira Fisher, 48, of St. Louis, had the procedure at Mercy less than eight weeks ago. Fisher's fibroid symptoms had worsened over the past three years. She had irregular and very heavy bleeding, fatigue, constant feeling of needing to urinate, cramping and bloating. With at least three large fibroids, her only option was a hysterectomy. But she did not want to lose her uterus and did not want to miss work as a physical therapist assistant.
Three days after having the procedure, Fisher said she was fully recovered. She's had one period, which was normal. "I feel lighter," she said. "I feel much more energetic. I am much more myself now."
The device has only been approved for women ages 35-50 who are finished bearing children. Studies are ongoing involving all women, including those who plan to get pregnant.
Because the device is new, not all health insurance companies have yet to approve coverage of the procedure, Levine said. "It's hit and miss whether an insurance company will pay for it," he said. "But these are women who are sitting on the sidelines looking for an alternative. … They are willing to fight the insurance company."