SIR 2019: UFE safer than myomectomy

Uterine fibroid embolization (UFE) is safer than myomectomy and is more effective in the treatment of heavy menstrual bleeding, according to research presented at the Society of Interventional Radiologists (SIR) annual meeting held March 23-28 in Austin, TX.

Jemianne Bautista-Jia, MD, a radiology resident at Kaiser Permanente Los Angeles Medical Center, and colleagues analyzed the rate of secondary interventions of 863 patients who underwent UFE or myomectomy from 2008 through 2014.

The 451 patients in the UFE group were older than the myomectomy group (mean age of 45 vs. 39 years), with more having multiple fibroids (86% vs. 72%), and smaller fibroids (6.9 cm vs. 7.7 cm). Twenty-seven patients in the UFE group had adenomyosis, a condition in which the inner lining of the uterus breaks through the muscle wall of the uterus., compared to eight patients in the myomectomy group. Both groups were analyzed for a mean of seven years.

“The patients who underwent a myomectomy had a higher rate of postprocedural complications,” said Dr. Bautista-Jia. “Twelve patients required blood transfusions during the postoperative period compared to only four patients in the UFE group, a three-fold higher rate. One myomectomy patient developed a pelvic infection, compared to five patients who underwent UFE, but this finding was not statistically significant. The number of patients requiring re-hospitalization was identical: 12 each.”

“In addition, only 9% of patients in the UFE group required secondary interventions compared to 11% in the myomectomy group. Patients having UFE also had shorter hospital stays and a shorter recovery time. And whereas only half of the myomectomy patients reported improvement in heavy menstrual bleeding, the rate was significantly higher for UFE patients at 75%,” she added.

“According to a Harris Poll conducted in 2017, only 44% of women diagnosed with symptomatic fibroids had heard about UFE,” noted Dr. Bautista-Jia. “It is important for interventional radiologists to educate their non-radiology colleagues, particularly gynecologists and general practice physicians, as well as reach out to the general population. While UFE is not appropriate for every woman with symptomatic uterine fibroids, it should be discussed as a treatment option by their doctors.”