title: [Therapeutic alternatives of uterine fibroids except medicinal treatment and embolization].
abstract: OBJECTIVE
  To summarize the existing literature on therapeutic alternatives to hysterectomy and myomectomy for management of symptomatic uterine fibroids other than medicinal treatment and embolization.
  
  
  METHODS
  Pubmed, Cochrane and Embase contents were searched up to December 2010.
  
  
  RESULTS
  The Nd:YAG laser appeared to be effective but equipment's cost and postoperative adherence risk limited its development. Bipolar, microwave and cryomyolysis are still investigational. Radiofrequency thermal ablation is a less aggressive alternative when feasible under ultrasound guidance. Focused ultrasound surgery MR or ultrasound guided is accessible to approximately 10% of uterine fibroids with a rate of 60-70% of long-term symptom relief. Data following laparoscopic uterine artery occlusion suggest that outcomes are similar to those with uterine artery embolization (UAE) but with less long-term durability; by transvaginal way, there seem to be more complications. The efficiency of acupuncture remains uncertain.
  
  
  CONCLUSIONS
  Numerous technical innovations have been developed. However, comparative studies with validated conservative options are still needed.
authors.affiliation: Département de gynécologie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnelé, 37044 Tours, France. louldamer@yahoo.fr
authors.forename: L
authors.initials: L
authors.lastname: Ouldamer
authors.forename: H
authors.initials: H
authors.lastname: Marret
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D017115:Catheter Ablation / Q000379:methods / Q000706:statistics & numerical data; D017679:Cryotherapy / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006176:Gynecology / Q000379:methods*; D006801:Humans; D053685:Laser Therapy / Q000706:statistics & numerical data; D007889:Leiomyoma / Q000628:therapy*; D008872:Microwaves / Q000627:therapeutic use; D011878:Radiotherapy / Q000379:methods / Q000706:statistics & numerical data; D055357:Uterine Artery Embolization / Q000379:methods / Q000706:statistics & numerical data; D014594:Uterine Neoplasms / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents