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New Treatment for Uterine Fibroids a Success

Study finds embolization as safe and effective as hysterectomy

MONDAY, April 8 , 2002 (HealthDayNews) -- In the latest study of fibroid treatments, which pitted the traditional hysterectomy against a new-age radiological treatment called uterine fibroid embolization, a winner seems ready to emerge.

Reporting at the annual meeting of the Society of Cardiovascular and Interventional Radiology in Baltimore today, radiologists from Georgetown University School of Medicine offer the most convincing evidence yet that the minimally invasive uterine fibroid embolization (UFE) could become the new gold standard for fibroid treatment and care.

"Our studies showed that in a head-to-head comparison with hysterectomy, the safety and efficacy of UFE was well-demonstrated," says study author Dr. James Spies, vice chairman of radiology at Georgetown University Medical Center. "Not only did it effectively treat the fibroids, it did so without major surgery."

Fibroid tumors are typically noncancerous growths that develop inside the uterus, usually during the latter part of childbearing years. Because the major symptom is heavy bleeding, the treatment of choice for decades has been a hysterectomy. The procedure, which removes the uterus, requires up to 10 days of hospitalization and weeks of recovery at home.

By comparison, UFE is minimally invasive and has almost no complication rate. In this treatment, doctors make a tiny incision in the groin and insert a slim catheter. They inject tiny chemical particles into the tube, which travel to the blood vessels that feed the fibroid. The tiny grains block the vessels, cutting off the blood supply to the fibroid, causing it to shrivel and die. Doctors report patients are back on their feet in a week or less, with only minimal discomfort.

"There's really no comparison in terms of how much less drastic this procedure is when compared to hysterectomy -- and with remarkably similar results," Spies says.

That's precisely what the research demonstrated.

In a study of 148 women diagnosed with fibroid tumors, 102 were treated with UFE, while the rest had a hysterectomy.

Before their treatment, all the women were asked to complete a questionnaire designed to measure their physical and mental quality of life as it pertained to their fibroid symptoms.

After each treatment and period of recovery, the women were asked to repeat the questionnaire. Doctors then compared the scores before and after treatment for each group, and compared the groups to each other.

Using the number 50 or higher as an indication of "normal," here's how the two procedures stacked up: In women who had a UFE, physical well being increased from 45 before treatment to 52 after treatment. Women who had a hysterectomy went from 41 before surgery to 51 afterwards.

In terms of mental well being, the UFE group went from 45 to 52, while those who had hysterectomy went from 41 before surgery to 50 afterwards.

Finally, among patients who had UFE, 94 percent said they were satisfied three months after treatment, compared to 95 percent of hysterectomy patients.

"The bottom line is UFE compared favorably to hysterectomy, in terms of alleviating symptoms, and it did a little better when it came to quality-of-life issues," Spies says.

For gynecologist Dr. Ernst Bartsich, any procedure that can reduce what he calls an "outrageously high rate of hysterectomy" should be seriously considered by any gynecologist.

"Any doctor who is truly interested in their patient's health and well being must explore every treatment option before they can help her decide which is the best treatment for her condition," says Bartsich, an associate professor of obstetrics and gynecology at New York Weill Cornell Medical Center .

While he doesn't believe embolization is right for every woman, he's certain it's worthy of consideration by every doctor treating a woman for fibroids.

"To automatically think hysterectomy every time you hear the word fibroid is to do women a great disservice, and that kind of thinking shouldn't be tolerated," Bartsich says.

Spies agrees: "We're not saying that UFE is the answer for all women. What we are saying is that, when applicable, women should be given a choice."

The new study also carries another important message, this one for the U.S. Food and Drug Administration.

The results of this study are being submitted to the FDA to help secure approval for UFE as a recognized treatment for fibroid tumors, a move experts hope will encourage gynecologists to accept the procedure as an important treatment option.

Currently, the FDA has approved embolization treatments for cardiac and other vascular conditions.

What To Do

To learn more about uterine fibroid embolization, visit The Society of Cardiovascular and Interventional Radiology.

To learn about a variety of treatment options for fibroid tumors, check out The Fibroid Place.

SOURCES: James Spies, M.D., associate professor and vice chairman, department of radiology, Georgetown University Medical Center, Washington, D.C.; Ernst Bartsich, M.D., associate professor, obstetrics and gynecology, New York Weill Cornell Medical Center, New York City; April 8, 2002, presentation, Society of Cardiovascular and Interventional Radiology annual meeting, Baltimore
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