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Fibroid Embolization: Good Outcomes

85% of Women Still Better 3 Years After Uterine Fibroid Embolization
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WebMD Health News
Reviewed by Louise Chang, MD

Jan. 3, 2008 -- Can women with painful fibroids get long-term relief without surgery?

Yes, suggests a study of 1,278 women who underwent uterine fibroid embolization (UFE, also known as uterine artery embolization or UAE). Three years after the minimally invasive procedure, fewer than 15% of women needed surgery or a repeat UFE.

The study was led by UFE pioneer Scott C. Goodwin, MD, who chairs the department of radiological sciences at the University of California, Irvine. Goodwin, who prefers the more precise term UAE, says the procedure offers "very good" long-term outcomes.

"The quality of life after UFE is good. And you have quicker recovery and fewer complications than with the surgical alternatives," Goodwin tells WebMD.

Moreover, Goodwin notes that the women in the study were treated at all kinds of medical centers, not just those highly experienced at performing UFE.

"That was important," Goodwin says. "You can conclude that UFE done by someone with the proper credentials will have the same outcome wherever it is done."

While 86% of the women who chose UFE said they'd recommend it to a friend or family member, not all of them remained symptom free. Three years after the procedure, about 13% of the women underwent surgery for fibroid symptoms and another 2% underwent another UFE.

That rate is comparable to the rate seen in patients who undergo myomectomy, surgical removal of fibroids. Each year after myomectomy, about 5% of patients see their fibroids return.

Worldwide, some 25,000 women undergo UFE each year. Goodwin introduced the procedure to the U.S. in 1996.

But the procedure is still considered "developmental" by many gynecologists, including Bryan Cowan, MD, chair of the University of Mississippi Medical Center department of gynecology and a spokesman for the American College of Obstetricians and Gynecologists.

"The three-year follow-up is short," Cowan tells WebMD. "I tell patients repeatedly: I can take your fibroids out but I cannot change you. After myomectomy, one-fourth of you will see them come back -- but that is five or six years later. So these people in the Goodwin study have not entered that time threshold."

Fibroid Symptoms, Fibroid Treatments

Fibroids are benign tumors -- not cancers -- that grow inside the uterus; doctors call them uterine myomas or leiomyomata. They usually don't cause symptoms. But when they do, women may suffer excessive or painful bleeding during menstruation, bleeding between menstrual periods, abdominal pressure, frequent urination, pain during sex, and/or low back pain.

Removal of the uterus -- hysterectomy -- is the only sure way to get rid of fibroids and to make sure they never come back. Fibroids are the reason for up to 40% of the 150,000 to 200,000 hysterectomies performed each year in the U.S.

Hysterectomy results in sterility. If a woman does not want her uterus removed, and her fibroids are not too numerous or too large, she may opt for myomectomy -- removal of the fibroids.

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