Uterine Fibroid Embolization Research Update

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Uterine Fibroid Embolization Research Update

A research study published on March 1, 2011 concluded that Hysterectomy should be the last choice when treating fibroids.

A recent study published in Radiology demonstrated how women who sought Uterine Fibroid Embolization (also knows as UFE, Uterine Artery Embolization, or UAE) 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.

The results of the study illustrates how after several years of 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.

This idea of ranking such procedures is called a waiting trade-off. Doctors view it as a method 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.

The study researched 62 women 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.

They also researched 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.

Lastly, they had reasearched 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.

Catherine A. Sewell, Md, MPH, an assistant professor of gynecology and obstetrics and director of the Johns Hopkins Fibroid Center in Baltimore states, “ 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.”

One weakness of the study, which is acknowledged by the authors, is that it only focused on abdominal hysterectomies, which involve an incision on the stomach to remove the uterus. Therefore, the study examined he most invasive surgical option with minimally or noninvasive interventional radiology options. But there are also less invasive ways to remove their uterus, either laparoscopically or vaginally, which may be more acceptable to patients.

All things considered, the results demonstrated that unless patients are having a lot of trouble with their fibroids or have dealt with them for a long time, hysterectomy will be their last choice. Dr. Sewell also concluded that,“The results are pretty clear in that people prefer to do the least invasive thing possible to get the biggest benefit.”

SOURCES:
Fennessy, F. Radiology, published online March 1, 2011.

 

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