Women who had less invasive treatment for painful uterine fibroids did about as well as those who had surgery, including a hysterectomy, according to 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 that often don’t cause any symptoms. While the most common treatment is surgery to remove tumors that cause extreme pain, some women choose a gentler procedure called uterine artery embolization.
However, the study found there were some trade-offs. While embolization patients spent far less time in the hospital, they also were more likely to need a repeat treatment.
Although the study did not address whether embolization can preserve fertility, it adds to growing evidence that this less drastic 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 George town University radiologist who had no role in the new research. Spies successfully treated Secretary of State Condoleezza Rice with fibroid embolization in 2004.
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 – the removal of the uterus – was the only option. Of the roughly 600,000 hysterectomies performed yearly in the United States, about a third are due to fibroids.
A more recent option is a myomectomy, surgery that removes the fibroids and keeps the uterus intact, allowing for a future pregnancy. However, there’s a chance the fibroids will return.
Since the 1990s, the popularity of uterine artery embolization has steadily grown. An estimated 13,000 to 14,000 embolizations are done each year in the U.S., according to the Society of Interventional Radiology. The procedure involves making a small nick in the groin and inserting a catheter in the artery. 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.
The new study was published in today’s New England Journal of Medicine.
