title: Nonsurgical Alternatives for Uterine Fibroids.
abstract: Uterine leiomyomata are the direct cause of a significant health-care burden for women, their families, and society as a whole. Because of the long experience with the mode of treatment, surgical myomectomy remains the gold standard for treating reproductive-age women; however, in the recent years, the wide evolution of less invasive approaches led to a change in the options used by the clinician to treat symptomatic fibroids. Minimally invasive procedures such as uterine artery embolization (UAE) are increasingly used to treat symptomatic fibroids. Other alternative treatments are becoming more diffuse, such as magnetic resonance-guided high-frequency focused ultrasound surgery (MRgFUS), cryomyolysis, vaginal occlusion, and laparoscopic closure of the uterine arteries. Both advantages and limitations of these techniques under development must be taken into account, but this wider range of choices is being increasingly considered for a tailored treatment. This article aims to enable health-care providers with the tools to provide the latest evidence-based care in the minimally invasive or noninvasive management of this common problem.
authors.affiliation: Department of Biomedicine and Prevention University of Tor Vergata, Rome, Italy. Electronic address: ezupi@libero.it.
authors.forename: Errico
authors.initials: E
authors.lastname: Zupi
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Centini
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Sabbioni
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Lazzeri
authors.affiliation: IRCAD, Hopitaux Universitaires, 1 Place de l'Hopital, 67091 Strasbourg, France.
authors.forename: István Máté
authors.initials: IM
authors.lastname: Argay
authors.affiliation: Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D003452:Cryosurgery; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D013813:Therapy, Computer-Assisted; D055357:Uterine Artery Embolization; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*
keywords: MRgFUS; UAE; cryomyolysis; fibroids; nonsurgical