Nonsurgical treatment called safe option for uterine fibroids
LOS ANGELES -- Women who had less invasive treatment for painful uterine fibroids did about as well as those who had surgery, including a hysterectomy, suggests a new study that lays out the options for a troubling condition affecting millions of women.
Uterine fibroids are common among women of child-bearing age. Nearly 40 percent develop these noncancerous growths in the uterus, and they often don't cause any symptoms. The most common treatment is surgery to remove tumors that cause extreme pain, but some women choose a gentler procedure.
The study, however, found there were some trade-offs to the popular procedure known as uterine artery embolization. While embolization patients spent far less time in the hospital, they also were more likely to need a repeat treatment.
Embolization involves making a small nick in the groin and inserting a catheter in the artery. Using real-time imaging, doctors then blast tiny pellets into the uterine artery to cut off the blood supply that feeds the fibroids. Over time, these tumors shrink and die.
Although the study did not address whether embolization can preserve fertility, it adds to growing evidence that this less aggressive approach is a safe alternative to a hysterectomy, the most common type of surgery to deal with painful fibroids.
"For some women, retaining a uterus is much more important than avoiding repeat surgery, particularly for younger women," said Dr. James Spies, a Georgetown University radiologist who had no role in the new research.
Fibroids are noncancerous growths of muscle fibers inside the uterus that can range from a quarter inch in size to as large as a cantaloupe. In serious cases, uterine fibroids can cause heavy menstrual bleeding, pelvic soreness, and pain during sex.
For decades, a hysterectomy -- removal of the uterus -- was the only option. Of 600,000 hysterectomies performed yearly in the United States, about a third are because of fibroids.
A more recent option is a myomectomy, surgery that removes the fibroids and keeps the uterus intact. As with embolization, there's a chance the fibroids will recur.
An estimated 13,000 to 14,000 embolizations are done each year in the United States.
The study was published in today's New England Journal of Medicine.
For more information, go to the New England Journal website at nejm.org or the Society of Interventional Radiology website at sirweb.org. 