• Vol. 43 No. 11, 550–558
  • 15 November 2014

Magnetic Resonance-Guided Focused Ultrasound Surgery (MRgFUS) of Uterine Fibroids in Singapore

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ABSTRACT

Introduction: Uterine fibroids are the most common type of gynaecologic benign tumours, occurring in 25% to 50% of women during their reproductive lives. About half of the affected women have clinically significant symptoms, including abnormal bleeding, menstrual pain, frequent urination, constipation and abdominal distension. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) has been used to treat patients with benign lesions and a variety of malignancies. The objective of this study is to evaluate symptom relief before and after MR-guided ultrasound ablation of fibroids.

Materials and Methods: A total of 37 patients with symptomatic uterine fibroids were treated in this study.

Results: MRgFUS treatment led to a significant, time-dependent decrease in not only Symptom Severity Scores (SSS), but also the mean fibroid volume. The average reductions in volume were 41.6% and 52.6% at 6 months and 12 months respectively (P <0.05). The mean SSS of the 37 patients was 41.7 ± 2.8 before treatment whereas the average SSS was 26.9 ± 3.6, 20.7 ± 3.4, 18.5 ± 3.6, 16.5 ± 7.1, 9.8 ± 3.6 at 3 months, 6 months, 1 year, 2 years, and 3 to 4 years respectively. The decrease in scores was significant at all time points up to 3 to 4 years (P <0.05 and P <0.001).

Conclusion: MRgFUS is a safe and effective non-invasive treatment for patients with symptomatic fibroids.


Uterine leiomyomas, or fibroids, are the most common type of gynaecologic benign tumours, occurring in 25% to 50% of women during their reproductive lives. About half of the affected women have clinically significant symptoms, including abnormal bleeding, menstrual pain, frequent urination, constipation, and abdominal distension. The conventional treatment for symptomatic women who have completed their families is hysterectomy, or myomectomy in women who wish to preserve their uteri. Many of these are open surgical procedures associated with risks such as infection and blood loss. According to reports from the United States of America (USA), an estimate of over US$2 billion is spent each year on hospitalisation for problems related to uterine fibroids, and more than US$4600 is spent on the treatment of fibroids per woman per year. Moreover, the cumulative rate of uterine fibroid recurrence at 12 and 24 months after abdominal myomectomy has been reported at 12.4% and 46.0%, respectively. Many women who wish to avoid surgical treatments or preserve the uterus increasingly seek less-invasive options. In order to reduce the cost, morbidity and lifestyle impact of surgery, several alternative approaches, for example, hormonal therapy, uterine artery embolisation (UAE) and focused ultrasound (FUS) surgery, have been used for the treatment of uterine fibroids.

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