Uterine fibroids are a common condition that affects up to 80% of women during their lifetime. Nearly half of these women then develop symptoms that affect their quality of life and fertility, including intense pain and anemia. Uterine fibroids remain today one of the main indications for removal of the uterus by hysterectomy. However, the Rochester team recommends minimally invasive therapeutic alternatives to hysterectomy.
The studyconducted among patients with uterine fibroids, reveals that:
- almost 60% of women undergoing hysterectomy for fibroid(s) had not previously received less invasive treatment; yet, alternative options to hysterectomy allow women to preserve their uterus;
- these alternatives include pharmacological therapies, hormone-releasing IUDs, radiofrequency ablation, focused ultrasound ablation, and uterine artery embolization;
- early detection is rare, although essential: when fibroids are detected early, they tend to be smaller and less extensive and their treatment is less complex;
- the incidence of fibroids increases with age until menopause and is higher in black women.
Diagnosing fibroids is simple with pelvic ultrasoundbut determining who should be screened is not, and screening usually occurs once the fibroids are large or symptoms are there. Many women with symptomatic fibroids report psychological suffering, including depression, worry, anger, and distress related to body image. The researchers therefore suggest that future research clarifies the benefits of expanded spite and early treatment.
Why so many hysterectomies? Hysterectomy is the most common treatment for uterine fibroids for several reasons:
- Hysterectomy makes decision-making easier for doctors and patients. In fact, the doctor does not have to determine which fibroids to treat or remove;
- hysterectomy is a surgery universally performed in obstetrics and gynecology departments;
- hysterectomy removes the risk of inadvertently missing a rare cancer that develops in the smooth muscle of the uterus, or leiomyosarcoma;
- Hysterectomy also eliminates the risk of recurrence or recurrence of fibroids: fibroids can reappear in approximately 50% of cases within 5 years following their removal.
Why avoid hysterectomy?
- preserving the uterus and ovaries has great health benefits;
- Removal of the uterus increases the risks of many diseases, including cardiovascular disease, depression, anxiety and mortality. These risks are even higher when the hysterectomy is performed at a young age.
Women considering a hysterectomy therefore need to be better informed, the researchers conclude. “particularly on less invasive options appropriate for many cases of fibroids”.
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