Dual Strategy for Fibroids Gives Good Results

For women with troublesome fibroids, the combination of two approaches results in better improvement than does surgery alone, according to a report from Taiwan.

For women with troublesome fibroids, the combination of two approaches results in better improvement than does surgery alone, according to a report from Taiwan.Surgical removal of the uterine growths — a procedure known as myomectomy — is commonly used when a woman doesn’t want a hysterectomy because she wishes to preserve her fertility, the authors explain, but blood loss from the operation remains a significant concern.Recently, it has been shown that tying off the uterine arteries supplying blood to the womb restricts the growth of fibroids, Dr. Wei-Min Liu from Taipei Medical University and colleagues note.The team combined the two procedures — ligation of the uterine arteries and myomectomy — and compared the outcome of this new procedure with myomectomy only for the treatment of fibroids in 342 women.Overall, symptoms resolved after surgery for more women treated with the dual procedure (98.7 percent) than those treated with myomectomy alone (81.5 percent), the authors report in the medical journal Fertility and Sterility.Among women who had suffered very heavy menstrual bleeding, all those who were treated with the combined procedure experienced symptom resolution within 2 months after surgery, compared with only 84 percent of women treated with myomectomy alone.Average operating time was somewhat longer with the new approach, the researchers note, but average blood loss was significantly lower during the combined procedure than during myomectomy alone.Fibroids recurred in 19.4 percent women who underwent only myomectomy, but there were no recurrences in the combined treatment group.Pregnancy and live birth rates after surgery were similar in the two groups.”Combined uterine depletion procedure and myomectomy for the treatment of symptomatic fibroids is a less invasive procedure that preserves the uterus and can preserve future reproductive capacity,” the authors conclude.However, they add, larger studies are necessary to be sure that this approach does not affect fertility or compromise fetal growth in the womb.(Source: Reuters, Fertility and Sterility, July 2004)