Display options
Cite
Tan N, McClure TD, Tarnay C, et al. Women seeking second opinion for symptomatic uterine leiomyoma: role of comprehensive fibroid center. J Ther Ultrasound. 2014;2:3doi: 10.1186/2050-5736-2-3.
Tan, N., McClure, T. D., Tarnay, C., Johnson, M. T., Lu, D. S., & Raman, S. S. (2014). Women seeking second opinion for symptomatic uterine leiomyoma: role of comprehensive fibroid center. Journal of therapeutic ultrasound, 23. https://doi.org/10.1186/2050-5736-2-3
Tan, Nelly, et al. "Women seeking second opinion for symptomatic uterine leiomyoma: role of comprehensive fibroid center." Journal of therapeutic ultrasound vol. 2 (2014): 3. doi: https://doi.org/10.1186/2050-5736-2-3
Tan N, McClure TD, Tarnay C, Johnson MT, Lu DS, Raman SS. Women seeking second opinion for symptomatic uterine leiomyoma: role of comprehensive fibroid center. J Ther Ultrasound. 2014 Apr 15;2:3. doi: 10.1186/2050-5736-2-3. eCollection 2014. PMID: 25512867; PMCID: PMC4265989.
Copy Download .nbib Format: NLM
Share it on

J Ther Ultrasound. 2014 Apr 15;2:3. doi: 10.1186/2050-5736-2-3. eCollection 2014.

Women seeking second opinion for symptomatic uterine leiomyoma: role of comprehensive fibroid center.

Journal of therapeutic ultrasound

Nelly Tan, Timothy D McClure, Christopher Tarnay, Michael T Johnson, David Sk Lu, Steven S Raman

Affiliations

  1. Department of Radiology, University of California, 757 Westwood Blvd, Los Angeles, CA 90095, USA.
  2. Department of Obstetrics and Gynecology, University of California, 757 Westwood Blvd, Los Angeles, CA 90095, USA.

PMID: 25512867 PMCID: PMC4265989 DOI: 10.1186/2050-5736-2-3

Abstract

OBJECTIVE: The objective of the study was to describe our early experience with a comprehensive uterine fibroid center and report our results in women seeking a second opinion for management of symptomatic uterine leiomyoma.

METHODS: We performed a HIPAA-complaint, IRB-approved retrospective study of women seeking second opinion for management of uterine fibroids at our multidisciplinary fibroid treatment center in a tertiary care facility from July 2008 to August 2011. After a review of patients' history, physical examination, and magnetic resonance imaging (MRI) findings, treatment options were discussed which included conservative management, uterine-preserving options, and hysterectomy. We performed Fisher's exact test for categorical variables between the cohort that did or did not undergo a uterine-preserving treatment. Differences were considered significant at p < 0.05.

RESULTS: The mean age of the 205 patient study cohort was 43.8 years (SD 7.5). One hundred sixty-two (79.0%) patients had no prior therapy. Based on MRI, one or more fibroids were detected in 178/205 (86.8%), adenomyosis in 8/205 (3.9%), and a combination of fibroid and nonfibroid condition (i.e., adenomyosis, endometrial polyp) in 18/205 (8.8%). In those who desired to transition their care to our institution (n = 109), 85 patients underwent 90 interventions: 39 MRgFUS (magnetic resonance-guided high-intensity focused ultrasound surgery), 14 UAE (uterine artery embolization), 25 myomectomies, 8 hysterectomies, 3 polypectomies, and 1 endometrial ablation. Five patients had two procedures. Intramural and subserosal fibroids were most commonly treated with MRgFUS followed by myomectomy and then UAE; in contrast, pedunculated fibroids were frequently managed with myomectomy.

CONCLUSIONS: Multidisciplinary fibroid evaluation may facilitate the increase use of less invasive options over hysterectomy for symptomatic fibroid treatment.

Keywords: Fibroid center; Fibroids; MRgFUS; Multidisciplinary

References

  1. Lancet Neurol. 2010 Feb;9(2):177-89 - PubMed
  2. Radiology. 1989 Jun;171(3):693-6 - PubMed
  3. Fertil Steril. 1998 Sep;70(3):580-7 - PubMed
  4. J Med Libr Assoc. 2003 Oct;91(4):450-9 - PubMed
  5. Obstet Gynecol. 2011 Feb;117(2 Pt 1):331-7 - PubMed
  6. Obstet Gynecol. 2006 Oct;108(4):930-7 - PubMed
  7. Value Health. 2013 Jul-Aug;16(5):797-805 - PubMed
  8. Am J Obstet Gynecol. 2006 Oct;195(4):955-64 - PubMed
  9. Radiology. 1988 Jan;166(1 Pt 1):111-4 - PubMed
  10. Radiology. 1988 Jun;167(3):627-30 - PubMed
  11. Fertil Steril. 2006 Jan;85(1):44-5; discussion 48-50 - PubMed
  12. J Am Coll Cardiol. 2002 Feb 6;39(3):471-80 - PubMed
  13. J Oncol Pract. 2010 Nov;6(6):e21-6 - PubMed
  14. Obstet Gynecol Clin North Am. 1995 Dec;22(4):667-725 - PubMed
  15. Am J Epidemiol. 2004 Jan 15;159(2):113-23 - PubMed
  16. Fertil Steril. 2009 Feb;91(2):566-74 - PubMed
  17. Fertil Steril. 2009 Apr;91(4):1215-23 - PubMed
  18. Fertil Steril. 1981 Oct;36(4):433-45 - PubMed
  19. Radiology. 1986 Feb;158(2):385-91 - PubMed
  20. Radiology. 2008 Oct;249(1):187-94 - PubMed
  21. Acta Obstet Gynecol Scand. 2005 May;84(5):478-82 - PubMed
  22. Hum Reprod. 2001 Nov;16(11):2427-33 - PubMed
  23. Am J Obstet Gynecol. 2003 Jan;188(1):100-7 - PubMed
  24. J Med Libr Assoc. 2007 Apr;95(2):164-72, e51-3 - PubMed

Publication Types