I read with interest “Abnormal uterine bleeding: a quick guide to evaluation and treatment” [April] by Linda Bradley, MD. However, I noted that she failed to mention the use of myolysis as a technique for treating uterine fibroids in patients who no longer desire fertility.
I have been using this procedure for 11 years and am convinced that myolysis should be practiced with increasing frequency in cases of moderate-sized fibroids, with or without the use of endometrial ablation or hysteroscopic resection. It is a disservice to patients not to include this procedure when discussing treatment options for fibroids.
Herbert Goldfarb, MD
Montclair, NJ
Dr. Bradley responds:
I’d like to thank Dr. Goldfarb for his comments on the management of abnormal uterine bleeding and fibroids. My article only included techniques that are widely used and validated by several centers. A review of the literature regarding myolysis shows reports of case series and/or personal experiences, not comparative trials, published from only 1 center.