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| |  DG DISPATCH - SCVIR: Uterine Fibroid Embolization Better Than Myectomy By Robert H. Carlson Special to DG News
SAN ANTONIO, TX -- March 9, 2001 -- The first head-to-head comparison determined that embolizing benign uterine fibroids alleviated excessive menstrual bleeding better than surgical removal. Embolization and surgical removal, or myectomy, are two alternatives which preserve the uterus compared to the standard treatment -- hysterectomy. The retrospective study, conducted at Stanford University School of Medicine, asked women six months after their procedure to rate their symptoms. Among 76 women who had uterine fibroid embolization (UFE), 90 percent said menorrhagia had decreased, compared with 61 percent of 36 women who had myectomy, said investigator Gloria L. Hwang, a Stanford graduate student, in her presentation here at the annual meeting of the Society of Cardiovascular and Interventional Radiology. Hwang said women also reported returning to normal activity far faster after UFE -- within six days versus 35 days for those who had myectomy. The two procedures were approximately equal in alleviating pain and pressure, two other major symptoms of fibroids. Another advantage of UFE is that it is performed under local anesthesia on an outpatients basis, while myectomy requires general anesthesia and patients are hospitalized for an average of three days, said Mahmood K. Razavi, MD, associate professor at Stanford and senior researcher on this study. He also said procedural blood loss is negligible with UFE as compared with myectomy. "After several years of offering UFE as an alternative to myectomy, it’s gratifying to finally be able to show that it is more appropriate therapy for many women," Dr. Razavi said. Myectomy involves surgical removal of fibroids either in an open procedure or through a laparoscope. UFE is a non-surgical procedure in which a catheter is placed into the patient’s femoral artery through an incision in the groin. Plastic or gel particles are fed via the catheter into arteries supplying the fibroids, shrinking and eliminating them. Three patients in the UFE group had complications, including one each with endometriosis, readmission for pain, and transient leg numbness. Seven in the myectomy group had complications including blood transfusions in two, and one each with wound infection, adhesions, readmission for ileus, chronic pelvic pain and chronic incision pain.
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