O-230 Newer non-invasive modalities in fibroid management

Abstract Fibroids are highly prevalent and may cause abnormal menstrual bleeding, pain, mass in pelvis, infertility or pregnancy complications. For years, surgery such as myomectomy or hysterectomy have been the main treatment option. However, the high costs, morbidity and often long hospitalization and recovery time have driven the need for more conservative options. Today, there is a paradigm shift in our approach to the management of fibroids. Depending on the age of the woman, number and location of fibroids, symptoms and her desire for fertility, one can choose a suitable option. Medical options such as progestin’s, GnRh analogues, GnRH antagonists, selective progesterone receptor modulators like ulipristal, mifepristone, aromatase inhibitors or the use of an intra uterine progestin releasing device give good relief of symptoms and temporarily shrink the fibroid. Many high intensity focussed ultrasound options with or without MRI guidance are now available. Uterine artery embolization has stood the test of time. Innovative new techniques such as transvaginal doppler guided vascular clamp, intrauterine ultrasound guided radio frequency ablation, percutaneous microwave ablation are now available to treat this common, often symptomatic and recurrent problem.