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Less invasive treatment for fibroids- sounds too good to be true!

Posted Dec 14 2008 10:06pm

Just because some procedures are less invasive than others doesn't necessarily mean they are better.The uterine artery embolization is a great example of a procedure that is not as great as it sounds.

Women who had less invasive treatment for painful uterine fibroids did about as well as those who had surgery, including hysterectomy, suggests a new study that lays out the options for a troubling condition affecting millions of women.

Uterine fibroids are common among women of child-bearing age. Nearly 40 percent develop these noncancerous growths in the uterus that often don't cause any symptoms. Though the most common treatment is surgery to remove tumors that cause extreme pain, some women choose a gentler procedure that allows them to keep their uterus.

However, the study found there were some trade-offs to the popular procedure known as uterine artery embolization. Embolization patients spent far less time in the hospital, but they also were more likely to need a repeat treatment.

If you have fibroids, you tried medical therapy, and you are now thinking about surgery, there are a couple of things you need to consider.

First, you need to think about whether you want to be able to have children or not. If you do, then you need to preserve your uterus. You shouldn't even be thinking about getting a hysterectomy. You really should consider a myomecytomy (surgery where we just remove each fibroid tumor individually and preserve your uterus).

The uterine artery embolization sounds great, but the truth is there is not a lot of evidence to support its use in women who want to preserve their childbearing ability. So why bother taking a chance on a surgery that can't guarantee you will be able to get pregnant in the future?

The American College of Obstetricians and Gynecologists says that though embolization is an option for women with fibroids, there's not enough evidence to show it's safe for those wanting to get pregnant.

Now if you don't want to have children, and your fibroids are a problem, why do you want to hold on to your uterus? Uterine artery embolization is a great option if you are older and have multiple medical problems and you are not a candidate for major surgery. But if you are healthy and able to undergo surgery, it would make more sense to go for a hysterectomy and remove the uterus. You can still leave your ovaries in, especially if you are less then 45 and don't want to worry about taking hormone replacement therapy.

If you don't want to have any more children, why do you need your uterus? It is just a source of uterine and cervical cancer. Now, a long time ago we use to think that the cervix (the lower part of the uterus) was needed in order to have orgasms. So we use to remove the uterus and leave the cervix in place. But later we realized that didn't make a lot of sense, since women still had to worry about cervical cancer after a hysterectomy. Now we know that orgasms come mainly from the clitoris, and the length of the vagina doesn't change during a hysterectomy, so you can still have a happy sex life just like before. Actually, sex may even be better after you remove a large uterus that was causing painful intercourse.

Any way you look at it, uterine artery embolization just isn't such a great procedure since it has a high failure rate (fibroids may continue to grow since your uterus is still there and your ovaries are working and producing estrogen, which feed the fibroids). I just don't see this less invasive procedure really being such a success, except in cases where one cannot undergo surgery.

Remember, if it sounds too good to be true it probably is!

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