Treating Fibroids Without Surgery
Study Shows Embolization Is an Alternative to Surgery
Jan. 24, 2007 -- A nonsurgical approach to the treatment of uterine fibroids is a reasonable alternative to surgery such as hysterectomy, a new study shows.
Researchers compared outcomes among women who received either surgery or the nonsurgical treatment, known as uterine embolization, for fibroids that produce symptoms such as painful menstrual periods and heavy menstrual bleeding.
Fibroids are benign tumors of the uterus.
On the plus side, women who opted for embolization had much shorter hospital stays and recovery times than surgery patients. But they also had higher treatment failure rates.
Within a year of initial treatment, about one out of 10 embolization patients required either a second embolization procedure or a hysterectomy to treat continued uterine bleeding or other symptoms.
Within three years of treatment, one in five patients who had embolizations had symptoms that required further treatment.
The findings are published in the Jan. 25 issue of The New England Journal of Medicine.
"Like many other minimally invasive medical treatments, there is a trade-off with uterine embolization," researcher Jonathan G. Moss, MBChB, tells WebMD.
"If the only concern is symptom relief, then it is hard to beat a hysterectomy. But many women don't want to lose their uteruses, or they have other reasons for not wanting surgery. Embolization may be an option for them."
In the decade since radiologists began performing the procedure in the United States, uterine embolization has become a common treatment for fibroids. In November 2004, Secretary of State Condoleezza Rice had the nonsurgical treatment.
Unlike surgery, which involves fibroid removal, embolization starves fibroids by choking off the blood supply that feeds them. Most fibroids shrink dramatically within six weeks, but symptom relief often occurs much sooner.
Comparing Embolizations to Surgery
The newly published study included 157 women treated for symptomatic fibroids at 27 hospitals within the U.K.
Roughly two-thirds of the women had uterine embolizations and the remaining third had surgery. Forty-three of the surgery patients had hysterectomies and eight had fibroids removed without removal of the uterus.
As measured by responses to a standardized questionnaire, the researchers found no significant differences in quality-of-life scores among the two groups a year after treatment.