Uterine fibroids are noncancerous tumors that develop in the wall of the uterus. They often cause no symptoms, and in that case, require no treatment. If symptoms do occur, they can include heavy bleeding, pelvic pain and/or pressure, frequent urination, and pain during sex.
While the most popular method of treatment is surgical (abdominal myomectomy or hysterectomy), surgery is just not necessary, as most of the surgical procedures for fibroids can be replaced with a completely non-surgical, outpatient procedure called UFE (uterine fibroid embolization). As you can imagine, these approaches are dramatically different when it comes to risks, recovery time, and cost. What are the advantages and disadvantages of the different methods, and which one should a woman choose to solve the problem with fibroids once and for all?
Let’s try to figure it out the key differences between myomectomy and UFE. These two treatment options allow women to keep the uterus (unlike hysterectomy), although every woman that undergoes myomectomy has to sign a medical release. This release states that she understands if there is too much bleeding during surgery, or if the Gynecologist can’t get the uterus back together, she will wake up from surgery without her uterus. This never happens during UFE as UFE is entirely nonsurgical.
2019 Research Shows Uterine Fibroid Embolization is a Durable Treatment with Fewer Complications
“The two treatment methods were relatively effective, and the UFE led to more favorable results,” said Dr. Jemianne Bautista-Jia, a radiologist of Kaiser Permanente Los Angeles Medical Center.
She noted that patients who had experienced UFE had less pain and less time for recovery, as well as less or no blood transfusions.
“Patients are often not fully informed about their treatment options,” says Dr. Bautista-Jia, and she hopes that her research will increase awareness of the procedure.
UFE is very different from other methods of fibroid treatment: the blood supply of the tumor is reduced through a tiny catheter the size of a piece of spaghetti. It does not require any surgical incisions and avoids the risks and long recovery of surgery.
Tiny particles are injected into the blood vessels that supply the individual fibroids to block it, and this leads to the death of the fibroids. The fibroids will then soften and shrink over time (a process that is very similar to what happens to fibroids during menopause). As the fibroids shrink, the uterus also shrinks and a woman’s symptoms begin to disappear. This approach results in fewer complications compared with myomectomy – surgery, which tries to remove the larger fibroid tumors from the uterus. Because the Gynecologists often cannot remove all of the fibroids, the ones that do remain after surgery will grow, and most women will need a second procedure to address these fibroids often within 5 years. This is in stark contrast to UFE which treats ALL of the fibroids that are present in the uterus at the time of the procedure, and therefore, UFE is typically needed only once.
The UFE (uterine fibroid embolization): one half of them had UFE, and the other half had myomectomy to treat fibroids. All women were monitored for seven years on average after the procedure.
The results showed that women who experienced myomectomy had higher rates of postoperative complications, such as the need for blood transfusion (2.9 percent for the myomectomy group vs. 1.1 percent for the UFE group).
Dr. Navid Mootabar, chairman of the department of obstetrics and gynecology at Northern Westchester Hospital in Mount Kisco, summed up that uterine fibroid embolization (UFE) is an excellent alternative to surgical treatment.
There is another important fact that is often omitted. It is proved that myomectomy does not relieve uterine fibroids forever. Sometimes, it takes two, three or more procedures, but this does not guarantee complete elimination of the tumor. The risk of recurrence is quite high, especially with multiple nodes, and in order to reduce it, the woman is forced to take hormonal drugs, which can adversely affect health.
Also, after the operation, a scar always remains on the uterus. It implies possible additional risks during pregnancy and requires cesarean section during birth.
Every woman should have an idea of what treatment options she prefers. The least invasive and safest current method is the uterine fibroid embolization (UFE), leaving the woman an option to get pregnant and have a full term birth naturally.
Moreover, it is worth noting that the less invasive, outpatient UFE results in a significantly lower cost in comparison to myomectomy. If you’ve been dealing with fibroids and suffering on the sidelines because you were only told about the surgical options, and that wasn’t appealing to you, look in to UFE.
*SOURCES: Jemianne Bautista-Jia, M.D., radiology resident, Kaiser Permanente Los Angeles Medical Center; Navid Mootabar, M.D., chairman, department of obstetrics and gynecology, and director-at-large, Institute of Robotic and Minimally Invasive Surgery, Northern Westchester Hospital, Mount Kisco, N.Y.; March 25, 2019, presentation, Society of Interventional Radiology annual meeting, Austin, Texas
If you would like to learn more about benefits of UFE, contact Atlanta Fibroid Center at 770-953-2600 or make an appointment online.