UFE or Acessa for my fibroids?

Published On: July 13, 2023

So, you have heard of a procedure called Acessa advertised as minimally invasive in the treatment of uterine fibroids. You are wondering if Acessa could be an option for you and how it compares to technology driven procedures like the UFE as well as to traditional surgeries like myomectomy and hysterectomy.
Here, you will find the answer to your questions.
Acessa is nothing more than a combination of laparoscopy and ultrasound to deliver heat to the fibroids which is supposed to make them shrink. In other words, during the surgery, the gynecologist is introducing/holding the laparoscopy probes as well as an internal ultrasound probe, searching for fibroids, implanting a needle with prongs in the fibroids and running heat through those prongs in each fibroid until they are deemed non-viable. To give a comparison, Acessa is more like a myomectomy with a twist but still many stitches!

So, consider the following:

  1. Acessa is performed in a hospital or surgical center setting, requires general anesthesia, and lasts about 2 hours.
  2. Acessa CANNOT treat all fibroids, especially those outside the wall or inside the cavity.
  3. Acessa CANNOT treat adenomyosis+++.
  4. Acessa requires good knowledge of ultrasound physics and technique.
  5. Acessa uses heat for treatment and the risk of burns to the tubes, ovaries, urinary conduits, and bowel is real.
  6. Acessa, like myomectomy, is not a definitive treatment, it is impossible to treat every single fibroid. Smaller fibroids cannot be treated and will take over.
  7. Complications? Here you go, from outside to inside: Skin burns, wound dehiscence, infection, blood loss with subsequent emergency hysterectomy, burn of adjacent organs like bowel, ovarian tubes and urine conduits, deep blood clots and lung collapse and issues of general anesthesia/laparoscopy.
  8. Finally, Acessa is only covered by a few insurances, and you will need pre-authorization. Why is that? Because Acessa comes with limited research, still involves hospital care, and has better alternatives like the UFE.

Now contrast that with the Uterine artery embolization, a truly minimally invasive procedure that requires no hospital stay, has a downtime of 5-7 days, is cost effective, has no major complications and best of all is a definitive treatment!