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This is the third installment of my geeky science series on the abstracts and posters presented at the Society of Interventional Radiology’s 32nd annual Scientific Meeting held March 1 – March 6, 2007.
Pregnancy after MRgFUS for Uterine Fibroids: First Experiences
Received an email message from a visitor who wanted to pass along this information about the additional ExAblate 2000 approvals by the FDA. Thanks for the update!
From the email message:
The FDA approved new software that allows the ExAblate 2000 incisionless surgery procedure to be performed more efficiently by permitting more sonications during the same treatment window. This means that women with fibroids can be treated faster and women with larger fibroids may now be eligible for the outpatient procedure. The greater the area of the fibroid that a physician can treat, the greater the symptom relief. The agency is also allowing the system to be used with a more powerful open MRI machine, which means the physicians will have an even more precise view inside the woman’s body.
You can click the links to view the full press releases on Insightec’s web site but I included excerpts…
I sense that some of you get a little nervous about pre-op testing so here’s some information. I’ll start with a quote from Lab Tests Online that provides a guide on test preparation:
One of the most important factors in determining the accuracy and reliability of your lab test is you, the patient. After all, it is a sample from your body (blood, urine, or some other specimen) on which the test will be performed. Therefore, it is essential that you do the following to ensure that the results will be useful:
Checked the mail and there it was. A message signed by my dashing young fibroid doctor (AKA Mighty Mouse):
I am happy to inform you that your recent Pap smear returned within normal limits.
These results are from an exam I had about 3 weeks ago. Everything is fine. My fibroids are shrinking. My symptoms have vastly improved. I feel well. In fact, I’m not scheduled for another exam by my GYN until next year. Read the rest of this entry »
That would be my Interventional Radiologist (AKA Batman). I had my 6-month post-UFE MRI on last Wednesday. Stay tuned for that post because the experience was pretty funny. Remember my first MRI? Much better this time.
So, I saw my IR on yesterday. The rest of this post is taken directly from a comment I left on one of my update posts in response to Aly Fibroids who just HAD to know my results:
I was so excited because I KNEW everything had to be smaller. I feel so well. Things just must look better inside.
From the original visitor question: (Click the link to view the entire comment.)
Tameka:…the doctor said that the fibroids sizes were relatively small compared to my uterus size. She was concerned about the size and wondered if I had more fibroids than the sonogram or something else. She recommended a D & C to see what else is going on? Has anyone every had a D&C during their fibroid experience?
I’ll leave a couple of links. Visit Wikipedia for general information and additional medical references including a D&C guide by the World Health Organization. Here’s a quote from the MedlinePlus Medical Encyclopedia:
D and C is a procedure to scrape and collect the tissue (endometrium) from inside the uterus. Dilatation (“D”) is a widening of the cervix to allow instruments into the uterus. Curettage (“C”) is the scraping of the contents of the uterus. The vaginal canal is held open by a speculum, and the opening to the uterus (cervix) may be anesthetized. The cervical canal is widened using a metal rod, and a curette (a metal loop on the end of a long, thin handle) is passed through the canal into the uterine cavity. The inner layer of the uterus (endometrium) is scraped away, and the tissue is collected for examination.
Dilation and curettage (Wikipedia)
D and C (Medline Plus/ US National Library of Medicine)
If you have a D&C experience or thoughts/questions, please leave a comment here.
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Related Post:
I just call it The Gator
From the original comment on the ExAblate (MRgFUS) procedure:
Ruth: I’ve been investigating ExAblate as a potential candidate for over a year now, and finally had my consult at Virtua in NJ, with a 2nd opinion at Weill-Cornell in NYC. I really want to hear from anyone who has had this procedure…
Other comments: (Click the link to view the whole comment or the off-site link for more info.)
aiyin: Here’s an alternative procedure for zapping those pesky uterine fibroids. Unfortunately, it is so new my gynecologist never heard of it … http://www.universitymri.com/imageguided/fus_faq.html
Ellen: I am hoping that I will be eligible. Three SEDATED hours in an MRI, belly-down, while they blast the fibroids with ultrasound.
aiyin: Here’s more about ExAblate:
http://www.uterine-fibroids.org/index.html
The Related Post at the bottom contains information I gathered from a TIME magazine article as well as a few links to the ExAblate (MRgFUS) site.
[Edited to add the ExAblate toll-free number (US): 1 866 EXABLATE (1 866 392 2528). Thanks Randee!]
Leave a comment if you have an ExAblate experience (pre- or post-treatment), questions, or thoughts.
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Related Posts:
New treatment uses sound waves to shrink uterine fibroid tumors
ExAblate 2000 (MRgFUS) non-invasive fibroid treatment receives two new associated approvals by the FDA
From the original visitor hysteroscopy experience question:
Anne Cagle: I’m having an exploratory hysteroscopy next week. Can anyone share their experience with the procedure with me? I am very nervous.
I found a couple of links with information about hysteroscopy. The Wikipedia link is pretty general. WebMD is more informative and includes this brief exam overview:
Hysteroscopy is a diagnostic and surgical procedure that makes examining the inside of the uterus possible without making an abdominal cut (incision). During hysteroscopy, a lighted viewing instrument called a hysteroscope is inserted through the vagina and cervix and into the uterus. Treatment can also be done through the hysteroscope during the same procedure.
Hysteroscopy usually takes 30 to 45 minutes and is done as an outpatient procedure. General anesthesia is usually used, although local or spinal anesthesia can be used instead. You should not eat or drink for at least 4 to 8 hours before having the test. A gynecologist or surgeon performs the procedure.
The uterus is filled with a fluid, such as normal saline or glycine. The hysteroscope is inserted through the cervix into the uterus so the inner surface of the uterus can be examined. Hysteroscopy can locate the cause of bleeding for many women.
Hysteroscopy (Wikipedia)
Hysteroscopy (WebMD)
My experience occurred during a hysteroscopic myomectomy. It was outpatient, under general anesthesia, and caused very little pain. The doctor inserted the camera to see the fibroids that needed to be “shaved” down. I was nervous about the procedure, especially the general anesthesia part. You can follow my experience through the Related Posts listed at the end.
If you have a hysteroscopy experience or thoughts/questions, please leave a comment here.
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Related Posts:
No longer freaking out over my fibroid surgery tomorrow
Memories before my myomectomy
Memories directly after my myomectomy
I just call it The Gator
Natural progression after viewing fibroid pictures. With all the shapes and sizes, you can see why getting an answer to the fibroid weight question can prove difficult.
Lots of thoughts about this in another post. The original fibroid weight question:
momma’s_girl: wondering how much a softball sized tumor would weigh… any ideas?
So, I set out to search for an answer. From a couple of my responses:
EclecticGeek: Heard fibroids can weigh several pounds but couldn’t find anything that related fibroid weight to approximate size. Started camping out at Google Scholar and PubMed typing in keywords to search (fibroid weight, weight of fibroids, fibroid weight calculation, etc.). I think part of the problem is the shape. Fibroids aren’t perfect spheres so you can’t use some standard formula. Also, I can’t find a consensus on the composition. I’m sure the percentage of whatever is in there varies also compounding the problem.
I was running out of ideas at this point. Fortunately, a contributor provided a spark to jump start my thought processes again. Yay! From the geeky fibroid weight comment:
fibroid free: Volume (V) = LxWxH ok then Mass=Vp (vol x density) ok but how do I get the density?? Then I searched some clinical abstracts and I did find a couple of abstracts listing average weight in surgery comparisons….this is fuzzy science from a Microbiologist/Biochemist so dont kill the messger… it was noted that an 9 cmx 3 cm ‘broid was listed on average as 350-400 grams. Ok so 1000grams = 2.205 lbs or 1 g = 0.002205 pounds (lbs) sooo….. 500g = 1.1 ilb; 350 g= 0.77 lbs and 400 g = 0.88 lbs
Ahhh. Yes, it’s becoming clearer. Hang with me for the last little bit. My “geek-like” response:
EclecticGeek: When I started reading what you said about volume, it clicked. Density is a problem but also shape. Women are getting different dimensions for the fibroids. Some get three (i.e. 7cm x 8cm x 9cm) and can use the formula you provided. More rectangular I guess(?). Some get only one (i.e 6cm) and would need the formula for a sphere (hence pi). For two dimensions (i.e. 9cm x 3cm), maybe use a cylinder calculation(?) that also requires pi.
Now, here is some review material, a few volume equations, and an online calculator. (Did I just sound like a teacher?)
Rectangular Prism
Rectangular Prism: V = l x w x h [i.e. 7cm x 5cm x 2cm = 70cm³]
Cylinder: V = ∏r²h [i.e. dimensions 9, 3: (3.14)(1.5cm)²(9cm) = 63.6cm³]
Sphere: V = 4(∏r³)/3 [i.e. dimension 9: 4(3.14)(4.5)³/3 = 381.5cm³]
Density: ρ = m/V (We will worry about density later after we get volumes and can find more mass info.)
Okay. Let’s get this “fibroid weight” party started. Post your thoughts, calculations, corrections, or other info. 
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Related Posts:
What are uterine fibroid tumors?
Psst… Where can I find pictures of fibroid tumors?
Can I pass a uterine fibroid?
Another popular search phrase – “pictures of fibroids”. I am hoping (one of these days) to figure a way to post the image I have of one of my fibroids. Acquired it after my Hysteroscopic Myomectomy. It actually shows where the doctor started shaving it down. Until then, here are a few sites to keep you occupied.
MayoClinic.com – How Fibroids Develop
Fibroids of multiple sizes (picture)
Fibroid locations (illustration)
MayoClinic.com – Signs and Symptoms
Degenerating fibroid (picture)
At MayoClinic.com, you can click the small thumbnail images to enlarge them.
Leiomyoma (Wikipedia)
Leiomyoma (fibroid) enucleated from a uterus (picture)
Notice the firm yet rubbery appearance.
Pictures of Fibroids (Flickr.com)
An interesting (dare I say, eclectic) assortment.
About Uterine Fibroids
MRI images of fibroids (scroll to the bottom of the page)
Know of other places to find fibroid pictures, photos, illustrations, or images? Want to comment on the ones listed here? Post your thoughts or questions.
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Related Posts:
OR-Live brings fibroid surgery video to your computer via medical webcasts
What are uterine fibroid tumors?
Would somebody tell me how much these dang fibroid tumors weigh?
Can I pass a uterine fibroid?
Stumbled upon a TIME magazine article as I wandered around the Internet looking for all sorts of fibroid information. It discusses the benefits of MRgFUS (Magnetic Resonance guided Focused Ultrasound). This non-invasive procedure simultaneously images, treats, and ablates targeted areas. Approved by the FDA in 2004, it is available at approximately a dozen US locations and is also performed worldwide.
Read the TIME magazine article: Giving Fibroids the Heat
Other informational links:
MRgFUS – Non-invasive treatment for uterine fibroid tumors
ExAblate 2000 MRgFUS system
ExAblate 2000 treatment centers in the US and abroad
[Edited to add the ExAblate toll-free number (US): 1 866 EXABLATE (1 866 392 2528). Thanks Randee!]
Can’t believe the small number of facilities offering this treatment. I hope it continues to steadily increase. We’ve got to spread the word on ALL options.
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Related Posts:
Does anyone have an experience with ExAblate (MRgFUS)?
ExAblate 2000 (MRgFUS) non-invasive fibroid treatment receives two new associated approvals by the FDA
Had the first of my two post-Uterine Fibroid Embolization appointments on Tuesday. I met with my Gynecologist and yes, he used the speculum…again. I was cool because I knew it would be the last time I had to experience “the Gator” for several months. YAY! Resisted the temptation to ask if he ever felt like a mechanic.
Became so excited from the thought of a Gator-free life that I forgot to ask him about fibroid weight. It seems that a lot of people are interested in an answer. I’ll work on it. I did manage to remember to invite my doctor here. I think it would be pretty funny if he visits only to see that I called him Mighty Mouse. I’m sure he’s accustomed to my sense of humor by now (Gulp, I hope).
I’m normally not one to compare doctors to superheroes but allow me to explain. Mighty Mouse was one of my favorite cartoons as a child. The best part was the theme. Hearing MM sing “Here I come to save the day!” made me grin each time. Fast forward to this year when I really needed help. The “dashing young fibroid doctor” stepped in and several times I actually thought I heard that theme from long ago. He literally saved the day.
So, I guess this is my insane way of thanking my doctor. I now sense my Interventional Radiologist cringing as he wonders how I will “thank” him. 
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Related Posts:
How do I find a good local fibroid doctor?
How do I evaluate or rate a fibroid doctor?
What questions should I ask my fibroid doctor?
The dashing young fibroid doctor
Look who’s talking about fibroids
