WOMEN'S HEALTH
August 15, 2010

Avoiding Hysterectomy

A new procedure that stops blood flow to uterine fibroids may provide an alternative to hysterectomy.

A new method called uterine artery embolization (UAE) might make hysterectomy unnecessary for fibroid sufferers. Fibroids, which grow on the uterus, can cause considerable pain and unusually heavy menstrual bleeding, which can lead to iron deficiency anemia. For many women, if medication doesn't work, hysterectomy has been the only option.

The women in both groups reported the same degree of improvements in quality of life, mental and physical, with most women reporting that their symptoms had improved greatly or were completely gone.

The researchers randomly assigned over 150 women to receive either hysterectomy or UAE. None of the women's fibroids had responded to medication, so surgery was the next step. In UAE, a catheter is inserted into the arteries that bring blood to the fibroids. By releasing tiny particles into these blood vessels, they are starved of oxygen and will eventually die.

The women were followed for five years after their respective surgeries, and questioned periodically about their quality of life, whether they had any lingering symptoms, and if any additional treatments were necessary.

The women in both groups reported the same degree of improvements in quality of life, mental and physical, with most women reporting that their symptoms had improved greatly or were completely gone. Over 80% of the women in both treatment groups said that they were very happy with the treatment they'd received.

About 25% of the women in the UAE group had to go back and have a hysterectomy, mostly because they still had heavy menstrual bleeding. About 10% of the women who'd had a hysterectomy initially had to return for additional procedures, but this was mainly due to persistent pain.

Some advantages of UAE are that it is less invasive than hysterectomy and it requires less recovery time, which in turn could cut down on medical costs. Also, it does not take away a woman's ability to have a child, which may make the procedure particularly appealing for some women. However, more research will be needed to thoroughly determine all the pros and cons of the procedure. In the meantime, it's a good idea to discuss all the available options with your doctor, and make the most informed decision you can.

The results were published in the June 20, 2010 issue of American Journal of Obstetrics & Gynecology.

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