Topics of Interest

Embolization has Better Long-term Results than High-Intensity Focused Ultrasound

Study: Outcome of uterine artery embolization versus MR-guided high-intensity focused ultrasound treatment for uterine fibroids: Long-term results.

Journal: European Journal of Radiology, 2013 (not printed yet)

Authors: Froeling V, Meckelburg K, Schreiter NF, Scheurig-Muenkler C, Kamp J, Maurer MH, Beck A, Hamm B, Kroencke TJ.

Study from: Medical University of Berlin, Germany

Problem: The first non-invasive, uterine sparing treatment of uterine fibroids, developed in 1995, was uterine artery embolization (UAE). UAE uses very small particles, injected through a thin tube placed in the groin and then into the uterine artery, to slow down the blood supply to the uterus. Without adequate blood flow fibroids die and shrink while normal uterine muscle stays relatively healthy. High intensity focused ultrasound (HIFU), approved by the FDA in 2004, focuses high frequency sound waves through a woman’s body and onto the fibroid, heating the tissue which causes fibroid cell death in the area. (see more about UAE and HIFU treatments for fibroids here )

The long-term success of UAE has been well-studied and HIFU less well-studied, but this paper reports patient satisfaction results 5 years after each treatment and compares them.

Study: UAE was performed for 41 women and HIFU performed for 36 women at the same university hospital in Berlin. Before and 5 years after treatment, women filled out questionnaires that measured how much their fibroid symptoms bothered them and how the fibroids affected their quality-of-life. The researchers also counted how many women in each group requested to have another treatment for fibroids because UAE or HIFU did not work.

Results: After 5 years, women who were treated with UAE had significantly greater improvement of symptoms and quality-of-life than women who were treated with HIFU. In addition, 66% of women who had HIFU requested other fibroid treatment during the 5 years, while only 12% of women who had UAE requested other treatment.

Authors’ Conclusions: Improvement of women’s symptoms and quality-of-life was significantly better after UAE, resulting in much less need for other treatments later on.

Dr. Parker’s Comments: Very good patient satisfaction and reduction of symptoms following UAE has been shown in many studies. HIFU has been less well-studied and results following treatment have not been as good. This study confirms that for most women UAE is a more effective treatment than HIFU. I do not have much personal experience with seeing women after either of these treatments since they are seen by the interventional radiologist who treated them. However, this information will be useful when I talk to women about non-surgical treatment options for bothersome fibroids.

 

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Fibroid Doctor William H. Parker

Dr. William H. Parker is a board-certified Fellow in the American College of Obstetricians and Gynecologists. Dr. Parker is an internationally recognized expert in fibroid surgery and research. Based in Los Angeles, California, he is considered one of the best fibroid surgeons for abdominal and laparoscopic myomectomy in the United States and abroad. He has been chosen for Best Doctors in America and Top Doctors every year beginning in the late 90's.

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