Abstract

Uterine fibroids significantly impact patients’ quality of life, often causing severe pain and other debilitating symptoms. Treatment options are limited, with hysterectomy being the most common, despite its long recovery time, loss of fertility, and potential early menopause. Alternative treatments exist but none have not become the standard of care and each have their own downsides. This study explores the feasibility of using cryotherapy for fibroid ablation and focuses on developing a catheter and an experimental, in vitro, model for testing.

A cryoablation catheter was designed based on commercially available cardiac ablation catheters, with modifications to increase the tip’s surface area. The catheter was optimized to maintain temperatures close to −89°C while avoiding ice blockages that could halt the procedure. Testing was conducted on three different tissue models, each designed to mimic real fibroid tissue, to determine which posed the greatest challenge for ablation. Tissue A, the densest, was identified as the most difficult to ablate and so was selected for further modeling.

The study demonstrated that the catheter could effectively ablate fibroids up to 5mm in size, reaching through the uterine wall thickness and treating fibroids in various locations. While a single ablation was insufficient to fully treat an average-sized fibroid, multiple ablations could enable treatment of submucosal and subserosal fibroids, offering a safer alternative to patients who want to keep their reproductive organs. Future work will explore further catheter modifications to treat intramural fibroids, either by increasing the ablation surface area or by ablating from the inside out, reducing the risk to surrounding tissues compared to heat-based ablation methods. Further development of the tissue model could enhance its accuracy and versatility for testing.