Uterine fibroid embolization (UFE) is a minimally invasive interventional radiology treatment that blocks the blood supply to the fibroid tumors, causing them to shrink and die, alleviating symptoms. Because it is minimally invasive, has a much quicker recover time than open surgery, and preserves the uterus, this newer treatment has become increasing popular among women. Uterine fibroids are very common noncancerous (benign) growths that develop in the muscular wall of the uterus in up to 40 percent of women age 35 and older and the cause of approximately 200,000 hysterectomies in the United States annually. Most women with symptomatic fibroids are candidates for UFE.
"Some gynecologists have been waiting for long-term data before being comfortable recommending the UFE procedure, and now that we have that data, I think women will be hearing more about UFE as a nonsurgical option. The results are comparable to myomectomy, a procedure in which the fibroids are surgically removed, but UFE is less invasive, and women recover from it more quickly," says James B. Spies, M.D., professor of interventional radiology at Georgetown University Medical Center and the study's principal investigator. "With any of the uterine-sparing treatments, growth of new fibroids is possible, and we saw this occurring in some patients during the later part of follow-up in this study. The same phenomenon is seen with myomectomy, with reintervention rates in the same range." Spies added, "The next step in fibroid research is to design direct comparative studies between the various therapies to provide data as to which patients are best suited for each treatment."
In this study, 182 of 200 patients completed five-year follow-up with data available for analysis, and 18 were lost to follow-up. Outcomes were assessed by a questionnaire and patient symptom status, interval interventions, and menstrual cycle regularity. Treatment failure was defined as hysterectomy, myomectomy (surgical removal of the fibroids) or repeated embolization or failure of symptom control for two follow-up intervals. Using this measure, 20 percent of patients had either failed or recurred with new fibroids at 5 years after treatment. Among this group, there were 25 hysterectomies (4 were non- fibroid related), 6 myomectomies and 3 repeated embolizations. Seventy-three percent of patients had continued symptom control at the 5-year follow-up interval.