Surgery Versus Embolization in Treating Fibroids

A new study has found that surgery for the treatment of symptomatic uterine fibroids results in fewer complications than embolization, but requires on average a significantly longer hospital stay.

Researchers of the University of Glasgow (UK) and the University of Edinburgh Medical School (UK) randomly assigned women suffering from uterine fibroids in a 2:1 ratio to undergo either uterine-artery embolization (UAE)--where the blood supply to the fibroids is blocked--or surgery, with 106 patients undergoing UAE and 51 undergoing surgery (43 hysterectomies and eight myomectomies). The primary outcome of the study was quality of life at one year follow-up, as measured by a questionnaire known as the medical outcomes study 36-item short-form General Health Survey (SF-36).

The results showed that after 1 year, the symptom scores in the surgical group were on the whole better than the UAE group. Within the first year period 13 of the UAE women had adverse symptom events (12%) compared with 10 in the surgery group (20%). Ten of the UAE patients needed a repeat treatment, either another UAE or hysterectomy. Additionally, after the first year, 14 women in the UAE group (13%) needed to be re-admitted to hospital, three for major adverse events and 11 for repeat treatment because the original UAE had not been successful. The results are published in the January 25, 2007, edition from The New England Journal of Medicine.

"In women with symptomatic fibroids, the faster recovery after embolization must be weighed against the need for further treatment in a minority of patients,” concluded Richard D. Edwards, M.B., Ch.B. of the University of Glasgow, and colleagues.

Uterine fibroids are benign growths or lesions that form inside the uterus of many women during their reproductive years. It is estimated that some 25% of white women and as many as 50% of black women are affected by them. However, it is only when they become painful or cause irregular bleeding that a doctor may advise their removal.


Related Links:
University of Edinburgh Medical School
University of Glasgow