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.

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.