Fibroid embolization is safe, effective long-term

NEW YORK (Reuters Health) - In women with symptomatic fibroids -- benign tumors inside the uterus that can lead to pain, abnormal bleeding and other symptoms -- a treatment called uterine artery embolization provides long-lasting improvements in symptoms and quality of life, according to a three-year follow-up study.

Within six months of having the procedure, patients' scores for their symptoms and for quality of life had returned to the range seen for women without fibroids, and the improvements persisted for the entire study period, the study team reports.

Fibroids, which are common in US women of childbearing age, have typically been treated with hysterectomy, Dr. Scott C. Goodwin of the University of California Irvine Medical Center, Orange, California, and colleagues note in the medical journal Obstetrics and Gynecology.

Uterine artery embolization, an alternative to hysterectomy, is a minimally invasive procedure, requiring an incision of less than one inch in the groin. A small tube, or "catheter," is inserted and tiny particles are injected to block the arteries that supply blood to the fibroids causing them to shrink.

Goodwin and his team analyzed the short- and long-term effectiveness and safety of uterine artery embolization in 1,278 women treated at 27 sites across the United States.

Before treatment, women with fibroids reported average symptom scores of 58.61 and a health-related quality of life score of 46.95. By six months after treatment, the average symptom score had fallen to 19.87, and continued to drop until it averaged 16.54 three years after treatment.

A similar return to normal range was seen for health-related quality of life scores; patients' average score had risen to 85.04 after six months, and reached 89.55 at three years.

Fewer than 3 percent of the women required surgery to remove fibroids during follow-up, while 9.79 percent required hysterectomy and 1.83 percent had an additional uterine artery embolization procedure.

Nearly 86 percent said they "strongly agreed" that they would recommend the procedure to family and friends.

"At three years after treatment, uterine embolization appears to be a safe, effective, and durable treatment in a variety of practice settings, with substantial improvement in symptoms and quality of life for the large majority of patients," the researchers write, adding that "any experienced community or academic interventional radiology practice" should be able to achieve similarly good results.

SOURCE: Obstetrics & Gynecology, January 2008.