New minimally invasive treatment as effective as surgery for uterine fibroids
USA: Uterine fibroid embolization (UFE) is the new minimally invasive and effective treatment of uterine fibroids. This minimally invasive uterine fibroid treatment has fewer post-procedure complications compared to myomectomy. These are the results of a recent study presented at the Society of Interventional Radiology's 2019 Annual Scientific Meeting. Additionally, this treatment also ablated the need for additional treatment compared to those who underwent surgery.
A uterine fibroid (leiomyoma) is a noncancerous tumor that occurs in the muscle cells of the uterus. These growths do not spread to other regions of the body and are typically not dangerous. While some women do not experience symptoms, others have very heavy and prolonged bleeding that can be debilitating, as well as pelvic pain and abdominal enlargement.
Uterine fibroids treatment ranges from monitoring the fibroids or administering medications to relieve the symptoms, to more invasive approaches, such as myomectomy and hysterectomy. UFE is a minimally-invasive treatment for uterine fibroids that is less painful. It is performed through a tiny incision in which through the use of real-time imaging, an interventional radiologist guides a catheter into the uterine arteries and then releases tiny particles to block the blood flow to the fibroid tumors. It preserves the uterus and allows women to get back to their lives sooner than surgical options.
The study is significant as past research have suggested that s U.S. women, a majority of whom will experience uterine fibroids by age 50. But they are largely unaware of UFE despite more than 30 years as an evidence-based treatment.
"Women have options for treating their uterine fibroids. UFE and myomectomy are procedures with similar efficacy and durability for treating fibroids, but UFE has fewer complications and shorter hospital stays," said Jemianne Bautista-Jia, radiology resident at Kaiser Permanente and lead author of the study. "There are important factors women should consider when choosing between the procedures. These factors include the risk of bleeding, a possibility of infections, and recovery time."
In the retrospective cohort study, researchers analyzed treatment outcomes of 950 uterine fibroid patients from Jan. 1, 2008 through Dec. 31, 2014. Half of the patients underwent UFE, a non-surgical treatment that eliminates the blood supply to fibroids, causing them to shrink or disappear. The other half were treated surgically through myomectomy, a procedure that removes existing fibroids.
Key findings of the study include:
- Women who underwent myomectomy had a higher rate of postprocedural complications, including a 2.9 percent rate of blood transfusion, which was significantly higher than the 1.1 percent rate for those who were treated using UFE.
- Patients in both treatment groups demonstrated a significant increase in hemoglobin one year after the initial procedure due to reduced bleeding.
- The two methods were comparably effective based on the rate at which secondary interventions--including UFE, myomectomy, and hysterectomy--were needed.
- Second interventions were completed in 8.6 percent of women who received an initial UFE compared to 9.9 percent for women who initially underwent a myomectomy.
- This study also showed similar rates of miscarriage for women who underwent either UFE or myomectomy.
Future research should explore the impact of all uterine-sparing fibroid procedures on pregnancy, which remains still poorly understood.