Procedure May Help Even More Women Avoid Hysterectomy

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May 25, 2000 (San Francisco) -- A procedure that shuts down blood supply to growths, called fibroids, in the uterus may offer an alternative to hysterectomy for some women, says a team of experts at a meeting of ob-gyns here this week.

Michael Brodman, MD, says the procedure can bring welcome relief from pain and bleeding for women but it is best reserved for women who are approaching menopause. He says, "this is not a final answer to the problem. A women who has [this procedure] is likely to need subsequent procedures in four years or so because the fibroids grow back." However, "if a woman is approaching menopause, this can be a good choice because it may just carry her to menopause without the need for a hysterectomy," he says. Brodman is an associate professor at Mount Sinai Medical School.

The procedure, called uterine artery embolization, is similar to noninvasive procedures used to treat some heart conditions. A small tube is inserted through a blood vessel in the groin and is directed to the uterus. Fibroids are noncancerous growths that start in the muscles of the uterine wall. Hines says the catheter carries particles that are shot into the main blood vessel, which supplies the tumors with blood needed to survive and grow. The tumors then shrink.

Once the blood supply is shut down, the uterus is likely to return to a normal size, says Brodman. That reduction in size means less bleeding, less frequent urination, less pain during intercourse, and "a reduction in abdominal girth," says Brian Hines, MD, a resident in gynecologic surgery at Mount Sinai who was also involved in the study. That was especially significant in their study, because each woman's uterus was as big as that of a woman who is three to six months pregnant, says Brodman.

Previous studies have suggested that this procedure is safe and effective for small fibroids, but it was unknown whether it would work for large fibroids. Hines says that in the 29 women who underwent the procedure in his study, the uterus shrank by about half afterwards. Also afterwards, 86% reported an improvement in symptoms. "The bigger the change in volume, the more likely the women were report decrease in symptoms," he says.

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