When it comes to treatment of uterine fibroids, you've got options. But when selecting between fibroid surgery vs UFE: how can you choose? Well, we've got some exciting news that may help! UFE is just as effective at treating fibroids as myomectomy surgery! 
Uterine fibroids are muscular tumors that develop in the wall of the uterus. They're typically non-cancerous, and may go unnoticed by some women. Symptoms of fibroids include heavy menstrual bleeding, frequent urination and pain during sex. Women with fibroids may also have a hard time becoming or remaining pregnant.
Many women are told that a hysterectomy (surgical removal of the uterus) is the answer to troubling fibroid symptoms. But women who don't want to have a hysterectomy have to choose between other treatment options, including Uterine Fibroid Embolization and Myomectomy.
UFE is a minimally invasive treatment. It involves threading a thin tube into the blood vessel that supplies a fibroid tumor. Then, we permanently block the blood vessel with an injection of small plastic or gel particles. That blockage causes fibroids to shrink over time. Myomectomy, in contrast, involves surgical removal of a fibroid tumor. It's a more invasive treatment, and if done as an open procedure instead of laparoscopically, research suggests that it comes with a higher risk of complications. However, it may be a better option for women who still want to become pregnant.
Even so, we need women to know their options. But only 62% of women know about UFE, according to recent surveys. And, to this day, we still perform hysterectomies 65 times more often than UFE. Which is why, today, we want to help you understand the outcome differences of fibroid surgery vs UFE. So that you can make a truly informed treatment decision.
In one recent study, researchers looked at data from 950 women, half of whom had UFE and half who had a myomectomy to treat fibroids. Both groups of women gave health updates for the following seven years.
After reviewing the data, the findings were pretty clear: the procedures were similarly effective fibroid treatments. Seven years after the procedures, women in both groups had higher hemoglobin levels. Hemoglobin rose because heavy bleeding improved.
When it came to follow up procedures, the UFE group fared better. While 9.9% of the myomectomy group needed secondary procedures, in the UFE group, that number was only 8.6%.
And, among the women who had a myomectomy, there were higher rates of post-surgical complications, including the need for a blood transfusion (2.9% versus 1.1% for those who had UFE).
Study author Dr. Jemianne Bautista-Jia said, "The two treatments were comparably effective [and] UFE resulted in more favorable outcomes." Additionally, the radiology resident at Kaiser Permanente Los Angeles Medical Center noted, women who had UFE had less pain and shorter recovery times. Those women also reported greater relief from heavy bleeding.
These benefits are so clear, but "Patients are often not fully informed of their treatment options...UFE and myomectomy are procedures with similar efficacy and durability for treating fibroids, but the UFE has fewer complications and shorter hospital stays." She hopes these study findings will help raise UFE awareness. She encourages all women with fibroids to discuss UFE with their doctors before deciding on a course of treatment.
Researchers kept following the study participants, checking in with them after 24 and 36 months. Here's what they found. Breaking down the statistics we mentioned earlier, of all the women, only 2 UFE recipients had received a second procedure by the 36-month checkup. In contrast, 7 myomectomy patients needed further surgery.
For both groups of women, the number of fibroids was still reduced by 50% at the 24 and 36-month follow-ups. (This, again, suggests that UFE yields equal or better results than fibroid surgery.) Still, one new finding gave a slight advantage to myomectomy. And that relates to tumor size.
At the 36-month check-in, women with myomectomy saw a greater decrease in their largest tumor size than women with UFE. At the same time, women who received UFE saw their uterine size decrease more than women in the other treatment group.
The longer researchers collect data, the more we learn about outcome differences between UFE and fibroid surgery. Recently, researchers released follow-up data that showed how women fared 4 years after UFE vs after myomectomy. And here's what we've learned.
In that time period, 29% of myomectomy patients needed a follow-up procedure. In contrast, just 24% of the women in the UFE group needed further intervention. Even better news for women who wish to grow their families? Twelve women in the UFE group reported a healthy pregnancy after treatment of uterine fibroids. But in the myomectomy group? Only six women went on to have children. (The study authors do point out that women weren't recruited to the study based on their desire to have kids. So the differences can also be linked to person preference. Still, it's promising news for women who hope to get pregnant after UFE.)
Clearly, there is a lot to consider when deciding how to address your fibroid diagnosis. Need more information to explore all your treatment options? We're here to help with treatment decisions. Click here to request an appointment with our fibroid experts in Houston, and we'll help you decide if you're a candidate for UFE treatment.
Sources: Contemporary OBGYN
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