Treating Fibroids Without Surgery
Study Shows Embolization Is an Alternative to Surgery
Comparing Embolizations to Surgery continued...
The median hospital stay for the surgery patients was five days vs. one day for the women who had the nonsurgical procedure. The median time away from work was 62 days for the surgery patients and 20 days for embolization patients.
Ten out of 106 patients in the embolization group did not achieve adequate symptom control and required either a repeat procedure or hysterectomy within one year. An additional 11 patients required additional treatment within three years.
The researchers will follow the women in the study for at least five years to determine if treatment failure rates increase over time, Moss says.
“Certainly fibroids can grow back, but most of the women in this study were in their late 30s and early 40s so it may not be a big issue,” he says.
The thinking is that most women in this age group who have uterine embolization procedures will enter menopause before new fibroids cause symptoms, Moss explains.
What About Fertility?
The big unanswered question about uterine embolization is whether it is an appropriate treatment option for women who want to preserve their fertility, Moss says.
Currently, surgical fibroid removal without removing the uterus is considered the treatment of choice for women with symptomatic fibroids who wish to conceive.
But Montreal gynecologist and reproductive endocrinologist Togas Tulandi, MD, says uterine embolization may prove to be a better approach for women who are not good candidates for this surgery, known as myomectomy.
In an editorial accompanying the study, Tulandi wrote that concerns that uterine embolization leads to early menopause have not been borne out by the clinical evidence.
But he tells WebMD that the clinical picture is less clear regarding other concerns related to fertility and childbirth.
Only about 150 pregnancies have been reported among women who have had uterine embolization procedures.
Tulandi is the associate director of the McGill Reproductive Center at Quebec’s McGill University.
“There are suggestions that miscarriage and premature delivery rates are higher among these women, and that postpartum bleeding may be a problem,” he says. “At this point, I think it is still premature to say that embolization is a reasonable treatment for women who want to preserve their fertility.”