UFE and Myomectomy Work Together to Treat Rare Fibroids
Alicia Armeli

Intracavitary uterine fibroids. Try saying that five times fast. Besides being difficult to pronounce, this type of fibroid that grows within the uterine cavity may also be a challenge to treat. Like other fibroids, intracavitary fibroids aren’t cancerous, but they can be the cause of horrendous symptoms like prolonged, heavy periods, anemia, and extreme fatigue. Ugh.

Each year, hundreds of thousands of women seek treatment to find relief from the pain and suffering they experience with uterine fibroids.1 But if you’re a woman with intracavitary fibroids, you may not be a candidate for some of the most effective minimally invasive treatment options.2 So what’s a girl to do?

Before the word hysterectomy (a surgery that removes the entire uterus) crosses your mind, new research says there may be another way. A study conducted at University of California Irvine Medical Center in Orange, Calif., found that using uterine fibroid embolization (UFE) and hysteroscopic myomectomy as a combination therapy may be a safe and effective uterine-sparing option for women who have intracavity fibroids.2

Treating intracavitary fibroids with only UFE has been linked with a higher complication rate and may be a problem for women with large fibroids.2,3 Successfully treating fibroids with myomectomy alone depends much on where fibroids are located as well as their size, which may make intracavitary fibroids a challenge to treat.2

UFE is a nonsurgical procedure performed by an interventional radiologist and works by blocking the vessels that supply blood to the fibroids, causing them to shrink and symptoms to improve. Hysteroscopic myomectomy is performed by a gynecologist and involves surgically removing fibroids through the vagina and cervix.

To investigate how these two therapies work together, researchers examined treatment among 10 women with intracavitary fibroids who wanted to avoid hysterectomy.2  Each patient underwent the UFE procedure and then hysteroscopic myomectomy was planned for approximately one to two months later.

Results showed a 90% clinical success rate.2  One patient expulsed, or passed a fibroid, six days after UFE which was then removed, and one patient decided against myomectomy because she remained symptom-free after UFE. Around two months later, five patients underwent successful hysteroscopic myomectomy to remove any avascular fibroids left over after UFE. Two patients were scheduled for surgery at a later date. The remaining patient underwent a hysterectomy because her symptoms didn’t improve after the combination treatment. No short-term complications were seen.

For many women, finding a treatment option that avoids taking drastic measures like a hysterectomy is just as important as getting rid of bothersome symptoms. And although more research is needed, this study can provide hope for women suffering from intracavitary fibroids, offering a potential way to avoid hysterectomy while still finding relief.

ABOUT THE AUTHOR   Alicia Armeli is a freelance writer and editor, registered dietitian nutritionist, and certified holistic life coach. She has master’s degrees in English Education and Nutrition. Through her writing, she empowers readers to live optimally by building awareness surrounding issues that impact health and wellbeing. In addition to writing, she enjoys singing, traveling abroad, and volunteering in her community. She is a paid consultant of Merit Medical.

REFERENCES

  1. US Department of Health and Human Services, National Institutes of Health. (2016). How many people are affected by or at risk of uterine fibroids? Retrieved from https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/people-affected
  2. Khalsa, B., Costantino, M., & Goodwin, S. (2017). Uterine artery embolization followed by elective myomectomy for the treatment of intracavitary fibroids: Preliminary experience. J Vasc Interv Radiol, Feb;28(2):S47.
  3. Spies, J. B. (2016). Current role of uterine artery embolization in the management of uterine fibroids. Clin Obstet Gynecol, Mar;59(1):93-102.
These 3 STDs Are on the Rise (…and Are Becoming More and More Difficult to Treat)

More than 1 million sexually transmitted diseases (STDs) are acquired every day worldwide.1 If you’re sexually active, STDs are a common fact of life. So common, in fact, that one in two sexually active Americans will get an STD by age 25.2

But an alarming trend is emerging. Three specific STDs are on the rise. According to the latest annual Centers for Disease Control and Prevention’s (CDC) Sexually Transmitted Disease Surveillance Report, more than two million cases of chlamydia, gonorrhea, and syphilis were reported in the US in 2016—a record high.3

The majority of the new diagnoses—a staggering 1.6 million—were cases of chlamydia, with young women making up nearly half of all infections reported.3 Closing in at second place was gonorrhea with 470,000 cases.3  Behind chlamydia, gonorrhea is the second most commonly reported disease in the US.4 And last, primary and secondary syphilis—the most infectious stages of the disease—had a reported 28,000 cases.3  Since 2015, chlamydia, gonorrhea, and syphilis have increased by 4.7%, 18.5%, and 17.6%, respectively.4

Superbugs & Antibiotic Resistance

Chlamydia, gonorrhea, and syphilis are infections caused by bacteria. So why not knock them out with a good ol’ fashioned dose of antibiotics? Generally, these STDs can be treated with antibiotics, but when they aren’t taken correctly (ahem…you didn’t follow your doctor’s instructions) or when they’re used too much, the result is a superbug that has evolved to protect itself from the effects of medications, making it resistant to treatment.5

Gonorrhea has developed the strongest antibiotic resistance with some strains of bacteria not even responding to any available antibiotics, whereas antibiotic resistance in chlamydia and syphilis isn’t as common but does exist.5 According to the CDC, this complicates successfully treating diseases like gonorrhea because there aren’t many effective drugs available that are both highly researched and tolerated.6

“Increases in STDs are a clear warning of a growing threat,” said Jonathan Mermin, MD, MPH, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention in a 2017 press release. “STDs are a persistent enemy, growing in number, and outpacing our ability to respond.”3

How Does This Affect Me?

Both chlamydia and gonorrhea affect women disproportionately because early infection may not show symptoms.4

Left untreated, each disease comes with serious health complications.4  Both chlamydia and gonorrhea can move into the upper reproductive tract—such as the uterus and fallopian tubes—and lead to pelvic inflammatory disease (PID). PID increases the risk of infertility, ectopic pregnancy, pelvic pain, and is linked to chronic conditions like uterine fibroids. Women can also pass chlamydia onto their newborns during delivery, which can lead to blindness and pneumonia. A woman with untreated syphilis is at a greater risk for stillbirth and infant death. What’s also alarming is if you’re infected with chlamydia, gonorrhea, or syphilis, you’re two to three times more at risk of contracting HIV.5

What’s Being Done?

Responding to the threat of antibiotic resistance, the World Health Organization (WHO) released new recommendations for health professionals to follow that reflect the most effective antibiotic treatments of these STDs.5

Both WHO and the CDC encourage national, state, and local health departments to track the patterns of antibiotic resistance to improve detection of the diseases. Safe sex practices, like using condoms and having open dialogue about STDs within the community, are also recommended.3,5

What If I Get Infected with Chlamydia, Gonorrhea, or Syphilis?

Don’t freak out just yet. Breathe. As mentioned, chlamydia and syphilis most likely can still be treated with antibiotics. If you’re infected with gonorrhea, the current treatment recommendation is what’s referred to as “dual therapy” or using two types of drugs together. This involves a single shot of ceftriaxone and azithromycin taken by mouth. According to the CDC, taking the medication as prescribed will stop the infection.7

What Can I Do to Protect Myself?

The wise, old saying goes something like this: An ounce of prevention is worth a pound of cure. That being said, STDs are nothing to be ashamed of, but it only takes one unprotected sexual encounter to acquire an STD. There are many things you can do to prevent STDs and keep you and your partner(s) healthy.8

  • Use a latex condom correctly. This means every time you have anal, vaginal, and oral sex.
  • Talk about it. STDs are nothing to be embarrassed about. Talk openly with your partner(s) before having sex. Discuss any questions or concerns you may have with your doctor.
  • Have fewer sexual partners. Reducing your number of sex partners can lower your risk of STDs.
  • Mutual monogamy. Engaging in a long-term mutually monogamous relationship with an uninfected partner is a dependable way to avoid STDs.
  • Get tested regularly. And require that your partner(s) get tested, too. Remember, many STDs may not have symptoms but can still result in serious health consequences. Share your test results with your partner(s).
  • Get vaccinated. For STDs like the human papillomavirus (HPV) and hepatitis B, vaccines are a safe and effective way to help you avoid health problems associated with the infections.
  • Abstinence. Those dry spells aren’t necessarily a bad thing. The most reliable way to prevent infection is to not have sex.

This month is National STD Awareness Month. Pledge today to practice safe sex by joining the CDC’s Treat Me Right Campaign. Become aware of the ways you can keep yourself safe and talk to your doctor about the care you need to be sexually active and healthy:

https://www.cdc.gov/std/sam/index.htm?s_CID=tw_STD0180189

ABOUT THE AUTHOR   Alicia Armeli is a freelance writer and editor, registered dietitian nutritionist, and certified holistic life coach. She has master’s degrees in English Education and Nutrition. Through her writing, she empowers readers to live optimally by building awareness surrounding issues that impact health and wellbeing. In addition to writing, she enjoys singing, traveling abroad, and volunteering in her community. She is a paid consultant of Merit Medical.

REFERENCES

  1. World Health Organization. (2016 Aug). Sexually transmitted infections (STIs). Retrieved from http://www.who.int/mediacentre/factsheets/fs110/en/
  2. American Sexual Health Association. (n.d.). Statistics STIs. Retrieved from http://www.ashasexualhealth.org/stdsstis/statistics/
  3. Centers for Disease Control and Prevention. (2017, Sep 26). STDs at record high, indicating urgent need for prevention. Retrieved from https://www.cdc.gov/media/releases/2017/p0926-std-prevention.html
  4. Centers for Disease Control and Prevention. (2017, Sep 26). 2016 Sexually Transmitted Disease Surveillance Report. Retrieved from https://www.cdc.gov/std/stats16/toc.htm
  5. World Health Organization. (2016, Aug 30). Growing antibiotic resistance forces updates to recommended treatment for sexually transmitted infections. Retrieved from http://www.who.int/mediacentre/news/releases/2016/antibiotics-sexual-infections/en/
  6. Centers for Disease Control and Prevention. (2018, Feb 15). Antibiotic-Resistant Gonorrhea. Retrieved from https://www.cdc.gov/std/gonorrhea/arg/default.htm
  7. Centers for Disease Control and Prevention. (2017, Oct 31). Gonorrhea Treatment and Care. Retrieved from https://www.cdc.gov/std/gonorrhea/treatment.htm
  8. Centers for Disease Control and Prevention. (2016, Mar 31). How You Can Prevent Sexually Transmitted Diseases. Retrieved from https://www.cdc.gov/std/prevention/default.htm