Fibroids can be treated without hysterectomy

Women with symptomatic uterine fibroids, which are benign tumours inside the uterus that often cause heavy menstrual bleeding, pain and other symptoms, can be treated with uterine artery embolisation. Uterine artery embolisation 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. Hysterectomy, on the other hand, is the surgical removal of the uterus. Researchers from the Academic Medical Centre studied 177 women with uterine fibroids and heavy menstrual bleeding. They were randomly assigned to undergo uterine artery embolisation or hysterectomy; 81 and 75 women in the two groups, respectively, underwent the procedures. There was a follow-up for two years. By that point, 19 of the 81 women who initially underwent uterine artery embolisation had undergone a hysterectomy. Further analysis showed that 62 per cent of women in the uterine artery embolisation group were symptom free, 27 per cent reported a great improvement, about 4 per cent were unchanged and none were worse. The findings suggested that hysterectomy could be avoided in more than 80 per cent of the cases. About 20 per cent of the women, however, may still need a hysterectomy, after two years. Although the success of hysterectomy is 100 per cent, it is a major surgery. About 9 per cent of the women who undergo hysterectomy need a second operation within 2 years for post-operative complications. The researchers feel that every woman should be offered uterine artery embolisation as an alternative to hysterectomy for symptomatic uterine fibroids.