The Acessa ProcedureTM for Fibroids - Healthy Alternative to Having A Hysterectomy

 According to the University of Chicago Medical School, women and men both have pelvic floors which may not work well with time. For women; the pelvic floor includes the ligaments, nerves, muscles, and tissues that support the bladder, vagina, uterus, and rectum. 

 There are many different treatments for pelvic disorders. For women with symptomatic fibroids, hysterectomy has always been a severe option which completely removes the uterus. Of the many other options, there’s just one option - Acessa radiofrequency ablation - that is minimally invasive, targets individual fibroids, has a short recovery time, and provides long-term results with a minimal likelihood the fibroid symptoms will return.

Types of pelvic disorders

There are three main types of pelvic disorders:

  • Urinary incontinence. An inability to control the bladder. Common symptoms include an urgent need to urinate, painful urination, and a feeling that the bladders doesn’t fully empty
  • Fecal incontinence. An inability to control the bowel. Symptoms include constipation, pain during bowel movements, and strain during bowel movements.
  • Pelvic organ prolapses. This disorder happens “when the "sling" or "hammock" that supports the pelvic organs become weak or damaged.” Symptoms include vaginal or rectal pain or pressure. A woman’s pelvis may feel heavy. Muscle spasms in the pelvic region may occur.
Some of the reasons pelvic disorders occur include childbirth, menopause, or a prior surgery. Lifting and straining, being overweight, and a congenital predisposition to pelvic disorder. Aging is a very strong factor. One in three women in America will develop a pelvic disorder by the time they reach age 60. Nearly half of all women over 80 will develop a pelvic disorder, according to the National Institutes of Health

Fibroids and pelvic disorders

Fibroids treatment are a common cause of pelvic disorders. Fibroids are noncancerous tumors. They grow in a woman’s uterus. Fibroids are also called leiomyomas.
Other causes of pelvic disorder include:
  • Endemetriosis. This condition occurs when uterine tissue grow on the bladder, a woman’s ovaries, or other organs – outside the uterus
  • Chronic pelvic inflammatory disease. This affects a woman’s reproductive organs.
  • Interstitial cystitis. This occurs when the bladder becomes inflamed.
  • Cervical or uterine cancer may be another cause – according to the Cleveland Clinic
  • Digestive disorders can also cause pelvic pain.
The treatments vary depending on what type of pelvic disorder a woman has.

What are uterine fibroids and why should they be removed?

Women’s Health Network states that most uterine fibroids are “small growths of knotty connective tissue that develop in different ways in or on the uterus. Many women have clusters of fibroids, which can grow to the size of an early pregnancy. Some women only have one or two that are very small. An enormous number of women have no idea they have fibroids at all until they are discovered by their health care provider in a routine exam.” 

While cancerous fibroids are rare, fibroids can cause a lot of health problems. Symptoms include heavy or irregular bleeding - often heavier during a women’s menstrual cycle. 

Fibroids can also cause:
  • Menstrual pain
  • The need to urinate frequently
  • Pain while having sexual intercourse
  • Abdominal pain
  • Back pain

Women with fibroids may have difficulty sleeping, may feel tired, and may feel self-conscious. Women with large fibroids may have hip and leg pain, difficulty walking, and swelling. The fibroid tumors can cause infertility

Women in their 20s do develop fibroids. Younger African-American women are more likely to develop fibroids. Fibroid development tends to slow or stop after menopause. Fibroids (according to Dr. Lee) an vary in shape and size. Doctors who treat fibroids need to understand these different shapes so they can “completely ablate the tumor.” 
Contributing factors to the formation of fibroids

An improper balance of estrogen and progesterone may contribute to the growth of fibroids. According to Women’s Health Network, xenoestrogens (mainly pesticides and growth hormones used in producing food) may be a contributing factor.
Genetics may account for why some women develop fibroids and others don’t. The Women’s Health Network believes emotions and stress may also be a contributing factor too. 

Reasons women consider a hysterectomy

Very Well Health reports that there are some non-elective reasons why a woman may have a hysterectomy. These reasons generally include emergency situations including:
  • Uncontrollable bleeding
  • Infections that don’t respond to medications or treatment
  • Cancer
  • Complications during the delivery of a child
Why women look for alternatives to a hysterectomy

The selection of an alternative to a hysterectomy centers around the type of pelvic disorder the woman has and what is causing the pelvic order – according to Lifeafterhysteretomy.com

For some causes, such as fibroid tumors, the Acessa™ Procedure is often the safer, more convenient, and less expensive choice.
  • There are always dangers with any invasive surgery.
  • Infections are a common risk. 
  • Some women fear that a hysterectomy will lead to early menopause. 
  • A hysterectomy is not an option for women who still want to have children
  • Women also fear that a hysterectomy will affect their sex life
  • Two primary reasons women focus on treatment of their fibroids are:
  • Heavy menstrual periods where bleeding occurs
  • The longer length of menstrual periods 

If the monthly blood loss becomes heavy, a woman may develop anemia which can also lead to consideration of treatments

The hysterectomy procedure

The agony of dealing with constant bleeding is what tempts most women to consider a hysterectomy or other procedures. In a hysterectomy, the entire uterus is removed. WebMd states that 600,000 women have a hysterectomy procedure each year. About 20 million women have had a hysterectomy procedure. The normal amount of time to recover from a hysterectomy is four to six weeks.
 
The preferred and recommended alternative to hysterectomy
 
The Acessa Laparoscopic Radiofrequency Ablation (Lap-RFA) 

This method uses ultrasound to target each fibroid individually - by using a small array of needles. The surrounding tissue and the uterus are not damaged. 

The many benefits of the Acessa procedure include these:
  • The procedure is minimally invasive
  • It’s an outpatient procedure 
  • Normal recovery time is three to five days
  • Unlike other hysterectomy alternatives, the Acessa procedure is designed to treat fibroid of different sizes and in different locations
  • Minimal chance that the debilitating fibroid systems will reoccur
  • Return to a normal quality of life
According to Fibroid.com, a study published in the Journal of Obstetrics and Gynecology in May 2013 confirmed that the Acessa radiofrequency ablation of fibroids procedure is quite successful. 

“94% of the women reported satisfaction with the treatment.”

The Myomectomy alternative to hysterectomy

The goal of this procedure is to surgically remove the fibroids from the uterine wall without affecting or removing the uterus. The procedure is normally done in one of two ways:

  • Laparoscopically. The surgeon enters through the navel. The procedure is an abdominal procedure.
  • A hysteroscopy. In this surgical procedure, a “telescope-like instrument is inserted through the vagina – only if the fibroids are mainly in the uterine cavity.” If the fibroids are not confined to the lining of the uterine cavity, other procedures must be considered. [WebMD article].

It takes about two to six weeks to recover. Women who want to bear children normally consider a myomectomy (or the Acessa™ procedure). The woman stays in the hospital for zero to two days.

Why myomectomy may not be a good alternative

According to our review of other medical journals:

  • 62.9% percent of patients who have this procedure were free of symptoms three years after the date of the procedure.  That means over one in three patients were not symptom-free three years later.
  • There is an initial 11.7% risk that fibroids will recur if the laparoscopic method is used. The likelihood of new fibroids grows to 84.4% in 8 years. A number of factors contribute to the possibility of new fibroids.
  • Possible risks of this procedure include “post-surgical adhesions and both intra- and post-operative bleeding.” “Cases of uterine rupture during pregnancy following a laparoscopic myomectomy have also been reported.”
  • While the uterus isn’t removed, complications can impair a woman’s fertility.
  • The medical management alternative to hysterectomy
  • There are many pharmacology treatments that may work depending on the extent of the pain, the bleeding, and other complications. Recommended medications differ depending on how close to menopause a woman is. Some of the recommended drugs include:
  • NSAIDS. Nonsteroidal anti-inflammatory drugs. Motrin is an example.
  • Drugs, according to Goodbyefibroids.com, that “’block the ovaries’ production of estrogen and other hormones.”

Women’s Health Network suggests that restoring the balance of the estrogen and hormones may help. Phytotherapy may be an option. Restoring the right hormonal balance is what most hormone therapies try to do. “Approved hormonal therapies include GnRH agonists, oral contraceptives, progestins, aromatase inhibitors (AI), and other hormone-suppressing drugs like mifepristone.” 

Each of these therapies includes known risks such as:

  • GnRH. Early menopause, reduced libido, mood swings, and other adverse effects. 
  • Oral contraceptives. “Women with pressure symptoms may not experience relief with oral contraceptives and progestins since they do little to shrink the fibroids or provide relief of bulk symptoms.”
  • Aromatic inhibitors. This therapy is considered experimental.
  • Mifepristone. Side effects include fatigue, lower libido levels, headaches, hot flashes, and other problems. 
Hormonal therapies are generally not advisable for long-term treatments.

Women’s Health recommends a healthy diet that has less foods with pesticides

Losing weight may help provide a better estrogen-progesterone balance – though there are many difficulties finding just the right diet. Alternative therapies may also include acupuncture and meditation.

The Uterine Artery Embolization (UAE) alternative to hysterectomy

This procedure is also called a uterine fibroid embolization (UFE). It’s a noninvasive procedure where a radiologist injects small particles into the uterine arteries. The aim is to cut off the uterine body blood supply – thus helping to kill or shrink the fibroids. Many patients do see positive results. Patients need to stay overnight in a hospital which means the procedure is expensive. It takes about 7-10 days to recover. 

The Highly Intensity Focused Ultrasound (HIFU) alternative to hysterectomy

HIFU, also called Magnetic Resonance Guided Focused Ultrasound (MRgFUS) is another option for treating fibroids. This technique “focuses a high-intensity beam of ultrasound energy on specific tissue.” It’s an outpatient procedure which doesn’t involve cutting, a catheter, or a needle. It’s FDA approved for premenopausal women who don’t wish to have more children but do have fibroids that present symptoms. Patients experience relief within three months. 
There are limitations though

The procedure can’t be performed on “the bowel, the pelvic bone, a skin fold, or an implanted device.” Larger fibroids are more difficult to treat. Repeat treatments may be necessary. 

The procedure is expensive and many insurers don’t cover the cost of the procedure. Only a few medical facilities offer MRgFUS. “Women who plan to get pregnant” are not indicated for the procedure.

Why Acessa™ is the Preferred Alternative to Hysterectomy

The Acessa Laparoscopic Radiofrequency Ablation (Lap-RFA) has numerous benefits including targeting the fibroids so that they don’t reoccur. 
  • Unlike medications,  Acessa™ is a long-term treatment
  • Unlike a hysterectomy, Acessa™ preserves the uterus
  • Unlike a Myomectomy, Acessa™ provides a stronger likelihood that the fibroids will not return
  • Unlike the United Artery Embolization procedure, Acessa™ has less recovery time and is less expensive
  • Unlike specialized ultrasound procedures, Acessa™ has few limitations and is less costly
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