March 1, 2011 -- Women who sought treatment to relieve the pain, heavy bleeding, or other symptoms caused by uterine fibroids report a better quality of life after their procedure, a new study shows.
But several years after recovering from one of three different interventions -- an abdominal hysterectomy, uterine artery embolization (UAE), or an MRI-guided focused ultrasound procedure, patients who had a hysterectomy said that, looking back, they might put off having that procedure almost two months longer than women who had the less invasive treatments.
That ranking, something doctors call a waiting trade-off, is a way to measure how long someone might opt to continue to live with their symptoms, rather than go through a procedure involving some discomfort, risk, and healing.
“Basically, we asked patients that knowing what they now know about the treatment that they had, how long would they put off having it?” says study researcher Fiona M. Fennessy, MD, MPH, a radiologist at Brigham and Women’s Hospital in Boston.
The 62 women in the study who had abdominal hysterectomies, in which the uterus is removed through an incision on the stomach, said they put off having that procedure an average of 21 weeks.
The 74 women who'd had a UAE, in which a catheter is threaded through the arteries to the fibroid and particles are injected that starve the fibroid of blood, said they’d put off having that procedure for about 14 weeks.
The 61 women who had an MRI-guided focused ultrasound procedure, in which a patient lies on an MRI table while ultrasound waves are used to pinpoint and destroy the fibroids, said they’d also wait an average of about 14 weeks.
The study will be published in the May issue of the journal Radiology.
“I think the study’s good because in some ways it quantifies for us kind of the risk-benefit analysis that patients do when we present them all the options for their fibroids,” says Catherine A. Sewell, MD, MPH, an assistant professor of gynecology and obstetrics and director of the Johns Hopkins Fibroid Center, in Baltimore.
“The results are pretty clear that people prefer to do the least invasive thing possible to get the biggest benefit,” says Sewell, who was not involved in the study. “And for most people, unless they’re really having a lot of trouble with their fibroids or have dealt with them for a long time, for most people, hysterectomy will be their last choice.”