Technology triggers debate about uterine fibroid treatment

A new, nonsurgical procedure has gained the attention of women and their physicians, but the jury is out on whether the technique is a panacea.

By Susan J. Landers, AMNews staff. Oct. 8, 2001.

Washington -- Uterine artery embolization is a new treatment for uterine fibroids that has sparked the enthusiasm of interventional radiologists, while inspiring a more cautious response from gynecologists.

The procedure, also known as uterine fibroid embolization, is a nonsurgical way to shrink the benign uterine fibroids that occur in 20% to 40% of women older than 35 and often cause pain and excessive bleeding.

Using a catheter inserted through a tiny opening in the skin, interventional radiologists cut off the blood supply to the arteries that feed the fibroids. As a result, the fibroids shrink or die.

The procedure is one of many carried out by the approximately 5,000 interventional radiologists who use miniature tools and imaging guidance in their work.

The technique, however, has yet to gain complete acceptance. These specialized radiologists are among its proponents, while some gynecologists are reserved in its application. In addition, many physicians consider it an area that brings with it lots of conditions for success.

Since it began being more widely used for uterine fibroids about five years ago, uterine artery embolization is being cited as an effective alternative to a hysterectomy and the uterus-sparing myomectomy. Both operations are performed frequently and require recuperations much longer than the one week normally required following an embolization.

About 15,000 to 20,000 embolizations have been performed in the United States during the past few years compared to about 400,000 hysterectomies performed each year to eliminate symptoms caused by uterine fibroids. [...]