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Cdn. study touts alternative fibroid treatment

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Date: Mon. Jan. 13 2003 10:46 PM ET

A Canadian study has found that an alternative method for treating uterine fibroids is just as effective as hysterectomies, but allows a woman to keep her uterus intact.

Uterine fibroids are non-cancerous tumours that grow on the uterus walls of 20 to 40 per cent of women over the age of 35. They aren't life-threatening, but they can cause monthly hemorrhaging and debilitating pain.

Jill McWhinnie had a uterine fibroid the size of a grapefruit. She says her monthly periods used to leave her exhausted and in pain.

"The main symptom I was experiencing was excessive, prolonged, monthly bleeding," McWhinnie says. "I had massive blood clots, and very severe menstrual cramps, as well -- to the extent that I had to be taken home from work."

Until now, hysterectomies were the standard treatment for fibroids. In fact, of the 50,000 hysterectomies are performed in Canada every year, one-third are due to fibroids. McWhinnie's doctor recommended a hysterectomy. She opted instead to take part in a Canadian study of a new treatment to shrink the fibroid without losing her uterus, with a procedure called uterine fibroid embolization.

The procedure involves having a doctor insert a thin tube through an artery to the uterus, says Dr. John Kachura, an interventional radiologist at Mt. Sinai Hospital in Toronto. The doctor then injects tiny, plastic particles the size of grains of sand. They block blood flow that feeds that fibroid causing it to shrink.

The entire procedure is performed under light sedation, and takes about 30 minutes.

"When you compare the benefits of uterine fibroid embolization compared to hysterectomy, it's less invasive and involves a shorter recovery period," says Kachura.

After tracking more than 500 patients, doctors in the study found embolization shrunk fibroids by 40 per cent. Most significantly, 80 per cent of women reported significant improvement in symptoms like excessive bleeding. The risk of complications was low, less than two per cent.

"The bottom line from this trial is that women now have a safe and effective treatment alternative to hysterectomies, and gynecologists have the evidence to support this and feel secure," states University of Toronto's Dr. Gaylene Pron, the lead author of the study.

Doctors are recommending the embolization treatment only for patients over 40, in part because they still don't know how it will affect the fertility of younger women.

Dr. Jennifer Blake, head of obstetrics and gynecology at Women's College Hospital in Toronto says there are women who have had uterine fibroid embolization and who have gone on to get pregnant, "but we have not have a long enough follow-up of women who have had UFE to say what the long term effect on fertility."

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