Study: Embolization Appears Better Than Myomectomy For Lessening Bleeding.(uterine fibroid embolization)

2001 MAR 15 - (NewsRx.com & NewsRx.net) -- Minimally invasive uterine fibroid embolization (UFE) appears to be superior to myomectomy in alleviating excessive menstrual bleeding, a major symptom of uterine fibroids, according to the first head to head comparison of the two main uterus-sparing treatments for the common problem.

Bleeding decreased significantly in more than 90% of women who had UFE compared to 61% of those who had myomectomy, according to a Stanford University study presented March 6, 2001, at the 26th Annual Scientific Meeting of the Society of Cardiovascular & Interventional Radiology. Early results show no statistical difference between the two therapies in alleviating pain and pressure, the two other major symptoms.

"Myomectomy typically is a surgical procedure, while UFE is not," said Mahmood K. Razavi, MD, associate professor of interventional radiology, division of cardiovascular and interventional radiology, Stanford University Medical Center, Stanford, California. "Recovery after UFE is typically five times faster and much less painful, and procedural blood loss is negligible as compared with myomectomy."

Both UFE and myomectomy are alternatives to hysterectomy, or removal of the uterus. More than a third of the more than 600,000 hysterectomies performed each year are due to fibroids.

UFE (also called uterine artery embolization, or UAE) is a nonsurgical procedure that treats all fibroids in the uterus and typically is performed while the patient is lightly sedated. Myomectomy is most often a surgical procedure performed under general anesthesia and removes only some fibroids, depending on their location in the uterus. Typically, the more fibroids a patient has, the less successful myomectomy is. Additionally, fibroids grow back several years after myomectomy in 10% to 30% of cases. Nearly 9,000 UFE procedures have been performed in the United States since 1996 and so far, regrowth has not been a documented problem.

In the Stanford study, 36 women had myomectomies and 76 women had UFE. After an average of nine months 91% of UFE patients and 61% of myomectomy patients reported the heavy periods they had experienced due to fibroids had significantly improved; 69% of UFE patients and 48% of myomectomy patients reported their pain significantly improved; and 73% of UFE patients and 95% of myomectomy patients reported pressure symptoms significantly improved. The differences between the two therapies in treating pain and pressure are not considered statistically significant, Razavi said.

According to the study, none of the UFE patients were hospitalized (all were done as outpatient procedures), while myomectomy patients were hospitalized an average of three days. While UFE patients required narcotics for an average of three days to treat post-procedure pain, myomectomy patients required narcotics for an average of six days. UFE patients returned to normal activity after an average of six days, compared to 35 days for myomectomy patents. While blood loss related to the treatment was minimal with UFE, it averaged 380 ccs for myomectomy patients, or more than three-fourths of a pint of blood. Three women (8%) who had myomectomy required transfusions due to excessive blood loss.