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    Nonsurgical Fibroid Treatment Deemed Safe

    But Questions Remain About Long-Term Effectiveness


    In an opinion released in January 2004, the American College of Obstetricians and Gynecologists (ACOG) acknowledged that nonsurgical embolization "appears to provide good short-term relief" for women who are appropriate candidates for the procedure.

    And the findings from the registry study were published in the July issue of the journal Obstetrics and Gynecology.

    Long-Term Outcomes Unknown

    But ACOG spokesman Bryan Cowan, MD, tells WebMD that the long-term effectiveness of the procedure has yet to be established.

    "We now know that about 25% of women who have myomectomies return for repeat procedures within five years, and that usually means hysterectomy," says Cowan, who is professor and chairman of the University of Mississippi Medical Center department of gynecology.

    "We are only just now beginning to get five-year data on a very limited number of (uterine embolization) patients."

    Cowan says uterine embolization appears to be a good option for women who aren't concerned about preserving fertility looking for a minimally invasive treatment for symptoms associated with fibroids.

    But all agree that the jury is still out on whether it is appropriate for those who want the option of having children. Although pregnancies have occurred in women who have had the embolization procedure, ACOG considers it inadvisable in women wishing to retain their fertility. They state that pregnancy outcomes remain understudied.

    "The good news is that we do know that patients can become pregnant after embolization, and it is certainly not anywhere near as final as having a hysterectomy," Spies says. "But the role of embolization in the treatment of women who want to preserve their fertility is not yet known."

    Spies is confident that long-term data provided by the registry will answer lingering questions about embolization.

    "ACOG is rightly concerned about long-term outcomes, and by following these women we will be able to address these concerns in a few years."

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