Our Summary

This research study looked at the long-term need for repeat procedures in women who have uterine fibroids. Uterine fibroids are non-cancerous growths in the uterus that can cause symptoms like heavy periods or pelvic pain. The study looked at three types of procedures that are less invasive than a full hysterectomy: myomectomy (removing the fibroids), endometrial ablation (removing or destroying the lining of the uterus), and uterine artery embolization (blocking the blood supply to the fibroids).

The researchers analyzed health insurance claims data for women aged 18-49 who had one of these procedures between 2008 and 2014. They followed up with these women for five years to see how many needed to have a repeat procedure.

They found that the need for repeat procedures varied by the type of initial procedure. After one year, myomectomy had the lowest rate of repeat procedures (4.2%), followed by uterine artery embolization (7.0%), and then endometrial ablation (12.4%). The five-year rates were higher: 19% for myomectomy, 33% for endometrial ablation, and 24% for uterine artery embolization.

The researchers also found that certain factors made it more likely that a woman would need a repeat procedure. These included having anemia, bleeding, pelvic inflammatory disease, and abdominal and pelvic pain before the first procedure. The study suggests that the risk of needing a repeat procedure should be considered when choosing a treatment for uterine fibroids.

FAQs

  1. What were the three less invasive procedures examined in the study for treating uterine fibroids?
  2. What factors were found to increase the likelihood of needing a repeat procedure for uterine fibroids?
  3. How did the need for repeat procedures vary by the type of initial procedure?

Doctor’s Tip

A doctor might advise a patient considering uterine ablation to discuss with their healthcare provider the potential need for repeat procedures based on their individual risk factors and preferences. They may also recommend regular follow-up appointments to monitor symptoms and discuss any changes in their condition. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help manage symptoms and reduce the risk of complications.

Suitable For

Patients who are typically recommended uterine ablation are those who have heavy menstrual bleeding, pelvic pain, or other symptoms related to uterine fibroids. These procedures may be recommended for women who want to avoid a full hysterectomy or who are not candidates for surgery. However, it is important to consider the potential need for repeat procedures and discuss this risk with a healthcare provider before undergoing uterine ablation.

Timeline

Before uterine ablation, a patient may experience symptoms such as heavy periods, pelvic pain, anemia, bleeding, pelvic inflammatory disease, and abdominal and pelvic pain. They may undergo initial procedures such as myomectomy, endometrial ablation, or uterine artery embolization to treat these symptoms.

After uterine ablation, the patient may experience relief from these symptoms. However, the need for repeat procedures can vary depending on the type of initial procedure. The rates of repeat procedures after one year were lowest for myomectomy, followed by uterine artery embolization, and highest for endometrial ablation. Factors such as anemia, bleeding, pelvic inflammatory disease, and abdominal and pelvic pain before the first procedure may increase the likelihood of needing a repeat procedure. It is important for healthcare providers to consider these factors when choosing a treatment for uterine fibroids.

What to Ask Your Doctor

  1. What are the different types of uterine ablation procedures available and how do they differ from each other?
  2. What are the potential risks and side effects of uterine ablation?
  3. How successful is uterine ablation in treating symptoms like heavy periods or pelvic pain?
  4. What is the likelihood of needing a repeat procedure after undergoing uterine ablation?
  5. Are there any factors that may increase the likelihood of needing a repeat procedure?
  6. What is the recovery process like after uterine ablation?
  7. How soon can I expect to see improvements in my symptoms after the procedure?
  8. Are there any restrictions or limitations on activities after undergoing uterine ablation?
  9. Are there any alternative treatments or therapies that I should consider before deciding on uterine ablation?
  10. How often will I need to follow up with you after the procedure to monitor my condition?

Reference

Authors: Davis MR, Soliman AM, Castelli-Haley J, Snabes MC, Surrey ES. Journal: J Womens Health (Larchmt). 2018 Oct;27(10):1204-1214. doi: 10.1089/jwh.2017.6752. Epub 2018 Aug 7. PMID: 30085898