Know the Implications of Your Fibroid Treatment Options
Women may not be fully informed about the implications of their uterine fibroid treatment decision. Factors include recovery time (return to work and daily living), symptom recurrence rate, need for post-procedure hormone replacement therapy, the risk of early menopause, cost and additional effects on the body.
Non-surgical (Minimally Invasive)
Uterine Fibroid Embolization (UFE)
Uterine fibroid embolization, sometimes called uterine artery embolization, is a non-surgical treatment that involves cutting off the blood supply to fibroids, causing them to shrink. UFE takes about one hour to complete, provides symptom control comparable to surgery, with a significantly shorter recovery time in approximately two weeks. UFE is performed by an interventional radiologist (IR), usually as an outpatient hospital procedure. Uterine fibroid embolization is not intended for women who desire future pregnancy. However, several studies have shown that women actively trying to become pregnant following UFE were able to do so.
Risks Associated with UFE
Uterine fibroid embolization (UFE) is a proven, safe procedure for treating symptomatic fibroids with minimal risk. Infrequent complications have been reported following UFE. Complications associated with UFE include, but are not limited to the following: short-term allergic reaction/rash, fibroid passage, recurrent/prolonged pain and groin hematoma.
A hysterectomy is the surgical removal of the uterus and often times the ovaries. The procedure usually requires a four-to-six week recovery period, and has a perceived association with numerous other long-term physical and psychological effects including incontinence, loss of sexual pleasure and depression. If the ovaries are removed along with the uterus before a woman reaches menopause, her risk of osteoporosis and heart disease increases. She may also need to consider if hormone replacement therapy (HRT) is necessary to control symptoms of surgical menopause. A woman is no longer able to have children after having a hysterectomy.
Risks Associated with Hysterectomy
A myomectomy is the surgical removal of fibroids while leaving the uterus in place. Since the uterus is left in place, a woman undergoing a myomectomy may still be able to have children. Like hysterectomy, a myomectomy is invasive and requires a long recovery period. There is also no guarantee that the fibroids will not return. Some studies have shown that up to 46% of women have recurring fibroid symptoms two years after their myomectomy.
Short-Term Fibroid Relief Medication
Medications called GnRH agonists offer short-term relief from fibroid symptoms. GnRH agonists induce a temporary chemical menopause by reducing estrogen levels causing the fibroids to decrease in size. However, the fibroids usually grow back to their pre-treatment size when the medication is discontinued.
A hysterectomy has been associated with numerous long-term physical and physiological effects including incontinence, loss of sexual pleasure and depression. The most common complications associated with hysterectomy are vaginitis, drug reactions, and urinary tract infections, with some more serious complications reported after 30 days including pneumonia, bowel injury, vaginal cuff herniation, and recurrent bleeding from the vaginal stump.