Outpatient Fibroid Treatment Beats Open Surgery
Most of the experts consulted by WebMD were quick to note that while normal pregnancies have been reported in women who have undergone UFE, the procedure is not currently recommended for women who intend to become pregnant.
Symptoms aren't the only thing that improves after UFE, according to a small study by Jackeline Gomez-Jorge, MD, assistant professor of interventional radiology at the University of Miami in Florida.
"It was very interesting to find out that this procedure does not adversely affect patients' sex lives, and, in fact, may improve them," Gomez-Jorge tells WebMD.
Gomez-Jorge and colleagues at Georgetown University gave a brief, nine-item questionnaire to 115 premenopausal patients who underwent UFE. Half the women responded to the explicit questions. The results:
- 64% of patients had no change in strength of orgasms
- 6% of patients reported stronger orgasms; 6% reported no orgasms
- 56% of patients reported internal orgasms with uterine contractions
- 80% of patients reported continued sexual desire more than once per week, vs. 8% who had no interest in sex
- 34% of patients reported sex more than five times in the last month
"It is my impression that by keeping the anatomy intact -- the nerve endings, the organs, and tissues -- to my mind it seems that would be an advantage to UFE," Gomez-Jorge says. "Of course, sexual response is more than anatomy -- but as far as the physical part, keeping your uterus, keeping your vagina, keeping the aspects that have to do with the sexual response may be an advantage. This is particularly true for those women who experience uterine contractions as part of their sexual response."
Yale interventional radiologist Michael G. Wysoki also studied sexual function in women who underwent UFE. In a telephone survey to which 21 premenopausal patients responded, his team found that 43% of patients had increased sexual desire. There was decreased pain during intercourse in 60% of women, and 27% reported increased frequency of orgasms.
Wysoki also asked the women about their gynecologists. Nineteen of the 21 women said it was they -- and not their doctor -- who initiated discussion of UFE. Most of these women learned of the technique on the Internet. All of the women said their gynecologist initially recommended hysterectomy for their fibroids -- and only one of these physicians ultimately offered UFE. This is not surprising, as only five of the 21 gynecologists had a positive opinion of UFE and more than three-quarters of them were strongly opposed to the procedure.
Eight of the nine women whose gynecologists remained opposed to UFE said they now had a new gynecologist.
"Women are taking charge of their healthcare," Wysoki says. "They are investigating options, especially on the Internet, and they are going to the gynecologist who offers them what they think are the best available treatment options. If their gynecologist is opposed to that option, they are going to switch doctors rather than fight with them."