North Carolina doctors now treating uterine fibroids with minimally invasive technique

Uterine fibroids are the most common cause of hysterectomy surgery, or removal of the uterus, with fibroids accounting for as many as half of the 600,000 hysterectomies performed in the United States each year.

But thanks to newer treatments and less invasive surgery, women suffering from fibroids can lose the painful symptoms while avoiding traditional hysterectomy and myomectomy surgeries. They have a quick recovery, getting back on their feet in just a few days.

Two minimally invasive outpatient procedures, Acessa and Sonata, use radiofrequency ablation (RFA) to treat fibroids. The fibroid cell tissues die when they are heated, causing the fibroids to shrivel and shrink, then eventually be harmlessly absorbed by the healthy surrounding tissues. Most women experience the most symptom improvement within three months and continued improvement for the first year.

Wondering if an RFA procedure is the right move for treating your fibroids? Your Novant Health OB-GYN can help address any questions you have.

In the meantime, here are answers to five common questions to help get your conversation started.

1. What are fibroids and what are their symptoms?

Fibroids are benign growths inside the uterus. They are a very frequently occurring condition, with as many as 80% of U.S. women experiencing fibroids by the time they are 50. Fibroids can cause a range of uncomfortable symptoms, including heavy menstrual periods, cramping, gas, infertility, pain during sex, fatigue, abdominal pressure and/or trouble urinating. Fibroids can be as small as a few millimeters or as large as several inches. They are different from cancerous tumors and do not typically lead to cancer

2. What are the advantages of RFA?

RFA is a targeted procedure, so it destroys only the fibroids, while preserving healthy tissue surrounding them. It is an outpatient procedure, meaning you don’t have to stay overnight in the hospital. The average RFA surgery takes around 90 to 120 minutes, depending on the location and number of fibroids.

Dr. Hillary Robinowitz-Elins completes the Acessa RFA procedure at Novant Health Huntersville Medical Center for patients of Novant Health Harbor Pointe OB/GYN – Poplar Tent in north Charlotte. She said it’s effective at treating the two most common types of fibroids – intramural (within muscle of the uterus), and subserosal (right under the “skin” of the uterus). Acessa can also be combined with hysteroscopic myomectomy, called Myosure, for submucosal fibroids (fibroids pushing into or already in the uterine cavity).

“Acessa provides more access as well as safer access to fibroids,” she said. “We also are avoiding painful uterine incisions, injury to normal uterine tissue, and avoiding a difficult recovery from traditional myomectomy.”

RFA is a highly effective procedure. Some results by numbers:

• In a clinical study of women who received the Acessa procedure, 82% of women had lighter periods and 94% were satisfied with the procedure after 12 months.
• In a clinical study of women who received the Sonata procedure, 95% had lighter periods and 97% were satisfied with the procedure after 12 months.

3. What is the difference between the Acessa and Sonata RFA procedures?

• Acessa is completed laparoscopically, which is sometimes known as a keyhole or Band-Aid surgery. The surgeon makes three tiny incisions in the abdomen, each one about 1/4-inch, to insert a camera, an ultrasound and the Acessa handpiece.
• Sonata is completed without any incisions. It uses an RFA treatment device that includes an ultrasound on the tip. The surgeon passes the Sonata treatment device through the vagina and into the uterus.
• Both procedures use ultrasound waves to locate the fibroids, and radiofrequency energy to destroy the fibroid tissue.

4. How much time off should I plan for my RFA procedure?

For most women, an RFA procedure entails two to four hours at outpatient surgery. After Acessa, most women resume normal activities in three to five days. Combined with Myosure, the recovery period remains an average three to five days. After Sonata, most women resume normal activities in two to three days. For either RFA procedure, you should plan to have someone drive you to and from the surgery, and you should avoid operating a vehicle or any strenuous activities for 24 hours because of anesthesia you will receive.

5. How do I know if I’m a good candidate for RFA?

Your clinician will help you decide if you are a good candidate for an RFA treatment. This will involve a pelvic exam, an ultrasound and sometimes an MRI. You’ll have an in-depth discussion about what you can expect from the procedure and your insurance coverage.