Treating Fibroids Without Surgery
April 11, 2002 -- Women with uterine fibroids who do not want to have hysterectomies now have an effective, nonsurgical option. And new research suggests that fertility can be maintained in many patients who have the procedure, known as uterine fibroid embolization (UFE).
Several teams of researchers who'd compared the nonsurgical treatment with hysterectomy and uterus-sparing surgery presented their findings this week at a medical meeting in Baltimore.
Uterine fibroids are common among women in their 30s and 40s, and they often cause severe pain and excessive bleeding. Fibroids are a leading reason why women undergo hysterectomy, or surgical removal of the uterus. Until recently, myomectomy -- in which fibroids are surgically removed -- was the only treatment option for women hoping to remain fertile.
Fibroid embolization is performed by interventional radiologists, who specialize in targeted, image-guided treatments. From a small incision in the groin, special sand-sized plastic particles are placed in the artery that feeds blood to the fibroid, effectively choking off its blood supply. Fibroids often shrink dramatically within six weeks, but relief of symptoms usually occurs much earlier.
Atlanta interventional radiologist John Lipman, MD, who has performed more than 500 fibroid embolizations, says most of his patients go home the same day, and 90% are soon symptom-free, without further interventions.
"I believe that in the near future, when more studies have been done, fibroid embolization will replace myomectomy as the treatment of choice for a large number of women," he tells WebMD.
Women with several fibroids or fibroids that are difficult to remove surgically may be good candidates for embolization, he says. While those with just a few fibroids that are easily accessible by surgery might have a better outcome with a myomectomy.
In one study presented at the Baltimore conference, researchers reported that a variation on the fibroid embolization procedure may help women in their 20s and 30s with fibroids maintain fertility. The researchers replaced the plastic particles widely used in UFE with particles made from a gel-foam sponge material. The gel-foam materials dissolved soon after treatment and allowed uterine arteries to reopen.