Our Summary

This research paper looks at two different ways to treat uterine fibroids (non-cancerous growths in the uterus) in women who don’t want to have their uterus removed. These two methods are Uterine Artery Embolization (UAE) and Myomectomy (MYO).

The researchers looked at 13 studies that compared the two treatments. They found that UAE had a higher chance of needing further treatment, leading to a hysterectomy (removal of the uterus), and severe symptoms four years after the procedure compared to MYO. However, UAE had a lower rate of early complications and less chance of needing to be re-admitted to the hospital. Both treatments showed similar improvements in pregnancy rates and abnormal bleeding.

In conclusion, both UAE and MYO are effective in treating uterine fibroids, but they can have different results. The researchers suggest that the choice between the two should be based on what the individual woman prefers and the doctor’s expertise.

FAQs

  1. What are the two methods of treating uterine fibroids discussed in this research paper?
  2. How do the outcomes of Uterine Artery Embolization (UAE) and Myomectomy (MYO) compare in terms of further treatment, complications, and re-admission rates?
  3. How should the choice between UAE and MYO be made according to the researchers?

Doctor’s Tip

A helpful tip a doctor might tell a patient about myomectomy is to discuss with their healthcare provider the potential risks and benefits of the procedure, as well as any alternative treatment options available. It is important for the patient to have a clear understanding of what to expect before, during, and after the surgery, as well as any potential complications that may arise. Additionally, the doctor may recommend certain lifestyle changes or medications to help manage symptoms and improve recovery after the procedure. It is important for the patient to communicate openly with their healthcare provider and ask any questions they may have to ensure they are well-informed and prepared for the myomectomy procedure.

Suitable For

Myomectomy is typically recommended for patients who:

  1. Desire to preserve fertility: Myomectomy is often recommended for women who want to maintain their ability to conceive and carry a pregnancy to term. Removing the fibroids through myomectomy can improve fertility and increase the chances of a successful pregnancy.

  2. Have large or numerous fibroids: Myomectomy may be recommended for patients with large fibroids or multiple fibroids that are causing symptoms such as heavy menstrual bleeding, pelvic pain, or pressure on surrounding organs. Removing the fibroids can alleviate these symptoms and improve quality of life.

  3. Wish to avoid a hysterectomy: Some women may prefer to avoid a hysterectomy (removal of the uterus) and opt for myomectomy instead. Myomectomy allows for the preservation of the uterus, which may be important for some patients for emotional or personal reasons.

  4. Have symptoms that interfere with daily life: Myomectomy may be recommended for patients who have symptoms such as pelvic pain, pressure, or urinary frequency that significantly impact their quality of life. Removing the fibroids through myomectomy can help alleviate these symptoms and improve overall well-being.

  5. Have failed other treatments: Myomectomy may be recommended for patients who have tried other treatments for uterine fibroids, such as medication or hormonal therapy, without success. In these cases, myomectomy may be a more effective option for symptom relief.

It is important for patients to discuss their symptoms, treatment goals, and preferences with their healthcare provider to determine if myomectomy is the right treatment option for them.

Timeline

Before myomectomy:

  • Patient experiences symptoms of uterine fibroids such as heavy menstrual bleeding, pelvic pain, frequent urination, and constipation.
  • Patient undergoes diagnostic tests such as ultrasound, MRI, or hysteroscopy to confirm the presence of fibroids.
  • Patient discusses treatment options with their healthcare provider and decides to proceed with myomectomy.

During myomectomy:

  • Patient undergoes pre-operative evaluations and preparation for surgery.
  • Myomectomy is performed to remove the fibroids while preserving the uterus.
  • Patient may stay in the hospital for a few days post-surgery for monitoring and recovery.

After myomectomy:

  • Patient experiences some pain and discomfort post-surgery, which is managed with pain medication.
  • Patient may have some vaginal bleeding and discharge for a few weeks after the procedure.
  • Patient is advised to avoid heavy lifting and strenuous activities for a certain period of time.
  • Patient follows up with their healthcare provider for post-operative care and monitoring of symptoms.
  • Patient may experience improvements in symptoms such as decreased menstrual bleeding, relief from pelvic pain, and improved quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about myomectomy include:

  1. What are the potential risks and complications associated with a myomectomy procedure?
  2. How long is the recovery time after a myomectomy surgery?
  3. Will my fertility be affected by undergoing a myomectomy?
  4. Are there any alternative treatments to myomectomy that I should consider?
  5. How many myomectomy procedures have you performed, and what is your success rate?
  6. Will I need to undergo any additional treatments or procedures after myomectomy?
  7. What can I expect in terms of symptoms and side effects after the myomectomy procedure?
  8. How will my fibroids be removed during the myomectomy surgery?
  9. Will my fibroids grow back after a myomectomy?
  10. What lifestyle changes or precautions should I take before and after my myomectomy surgery?

Reference

Authors: Peng J, Wang J, Shu Q, Luo Y, Wang S, Liu Z. Journal: Sci Rep. 2024 Aug 20;14(1):19252. doi: 10.1038/s41598-024-69754-0. PMID: 39164326