April 4, 2006

Newer Procedure Safer than Surgery for Fibroids

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - For dealing with fibroids in the uterus, a procedure called uterine artery embolization (UAE) is not only effective, but also safer than conventional surgery. Moreover, UAE usually requires a shorter stay in the hospital, according to a study presented at the annual meeting of the Society of Interventional Radiology in Toronto.

UAE blocks the blood supply to the fibroids, causing them to shrink and die. Dr. Sanjoy Kundu told Reuters Health that "90 percent to 95 percent of patients with symptomatic fibroids are probably candidates for UAE."

He thinks that there will continue to be a role for certain surgical procedures, such as removing larger fibroids, but other procedures such as complete hysterectomy may be phased out over time.

Kundu's group, at Scarborough General Hospital in Toronto, reviewed the outcomes of 378 women who were treated for symptomatic fibroids at their center over a two-year period. The treatments included UAE for 65 patients, surgical removal of fibroids in 47, and various types of hysterectomy for 266 women.

"We had a 100 percent technical success rate with UAE," Kundu said. The procedure was associated with 90 percent and 85 percent success rates for relieving heavy bleeding and pelvic pain, respectively, he added.

Twenty major complications occurred in the surgery group, mostly with hysterectomy. These complications ranged in severity from anemia requiring blood transfusion in eight cases to the death of one patient. In addition, a few cases of infection were noted with the surgical procedures.

By contrast, no major complications or infections occurred with UAE. The average length of hospital stay in the UAE group was shorter than in the surgical group: 1.2 vs. 3.5 days.

Kundu said that while these findings represent the experience of just one center, "over 150,000 UAEs have been performed worldwide" with similar high rates of success and low complication risks.