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Received a consultation from a patient with uterine fibroids today:
I have a uterine fibroid that is 6.8 cm in size. The ultrasound examination showed that the fibroid is in the posterior wall of the uterus. I learned that focused ultrasound ablation can preserve the uterus and treat uterine fibroids without surgery or bleeding. It is because the recovery is fast after the operation, and I really want to choose this method. However, I heard that the focused ultrasound ablation of the uterine fibroids in the posterior wall is not effective. Is this true?
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The effect of focused ultrasound ablation in the treatment of uterine fibroids is also affected by many factors, such as uterine fibroids. Blood supply, location of fibroids, surrounding environment of fibroids, degree of obesity of patients, preoperative preparation, pain threshold of patients, etc. Before treatment, pelvic plain scan plus enhanced magnetic resonance examination and airborne ultrasound localization examination can be used to evaluate whether it is suitable for focused ultrasound ablation surgery, and to predict the difficulty and effect of treatment, and then determine whether to choose this method of treatment. The effect of focused ultrasound ablation for most posterior uterine fibroids is very good.
Then how do we know the effect of focused ultrasound ablation? After focused ultrasound ablation of uterine fibroids, as long as there is no blood supply in the fibroids, it means that the fibroids have been successfully ablated and necrotic, which can be judged by contrast-enhanced ultrasound and enhanced MRI.
Focused ultrasound ablation to ablate the fibroids to cause coagulation necrosis, the necrotic fibroids are still there. The original position of the uterus, but the fibroids at this time have become inactive and will not continue to grow. The leukocytes, neutrophils and other cells with the function of phagocytosing foreign bodies in the surrounding normal tissues will slowly absorb the necrotic fibroids.
In general, 3 months after focused ultrasound ablation, most of the necrotic fibroids can be absorbed by about approx. 45%, about 60% can be absorbed 6 months after surgery, some patients will be completely absorbed by fibroids, some patients will no longer change due to physical factors, scarring or calcification of necrotic fibroids, and some submucosal uterine fibroids after surgery It can be discharged by itself.
case sharing
Ms. Chen is 41 years old, with uterine fibroids of 62mm*58mm, located in the posterior wall of the uterus, rich in blood supply, and has a history of two cesarean sections. The abdominal wall scars are obvious, the pelvic adhesions are heavy, and the operation is difficult. Through bladder training and the doctor’s extensive experience, Ms. Chen’s fibroids were successfully ablated. The fibroids that were originally “little suns” became a “black hole”, and the fibroids lost their blood supply!
Technologies, products, etc. are only used for expression, and do not have any treatment suggestions. For specific treatment methods, please go to a regular hospital for professional examination and treatment. Hot text introduction* How much is normal menstrual flow? A trick to teach you to quickly judge* Will women who do not have sex get gynecological diseases? * Five behaviors that hurt the uterus, try to avoid it! * Women often suffer from low back pain. Have you ever wondered why? * Everyone knows “big aunt”, do you know what “little aunt” means?
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