Uterine fibroids are benign pelvic tumors that occur in as many as one in five women during their childbearing years. Although not all fibroids cause symptoms, some women experience heavy bleeding, pain and infertility. Treatment options include hysterectomy, minimally invasive uterine artery embolization (UAE) and a noninvasive MR-guided focused ultrasound (MRgFUS) procedure.
"When discussing treatment options for women with uterine fibroids, the pros and cons of each treatment option need to be outlined," said the study's lead author, Fiona M. Fennessy, M.D., Ph.D., assistant professor of radiology at Harvard Medical School. "But until now, we haven't been able to evaluate all of the options with health-related quality-of-life measures, assessing symptom relief as well as the pain, anxiety or recovery time associated with the treatment itself."
In the study, researchers surveyed a total of 197 women who underwent hysterectomy (62), UAE (74) and MRgFUS (61) for symptomatic uterine fibroids between 2004 and 2006. The mean ages of the women in three groups were 47, 44 and 47, respectively.
A utility weight (a single unit of measure that encompasses all the different quality-of-life benefits from a health care intervention) was obtained for each of the fibroid treatment options, allowing comparisons of quality of life before and after treatment.
In addition, short-term utility weights for the actual treatments the women underwent were compared, allowing comparison of the actual treatment experiences among the options. To do this, the researchers used the waiting trade-off (WTO) method, which is based on the fact that people tend to wait longer to avoid unpleasant tests or procedures. Analysis by the WTO method provides short-term quality-of-life tolls in terms of quality-adjusted life-weeks.
"Quality of life significantly increased following each of the fibroid treatment options," Dr. Fennessy said. "But patients rated the non- or minimally invasive treatments –UAE and MRgFUS – more favorably."
Patients who underwent a hysterectomy reported that they would wait 21 weeks in order to avoid the procedure, while patients in the other two groups said they would put off their procedures by only 14 weeks.
The minimally invasive UAE procedure, which is increasingly used as an alternative to the surgical removal of the uterus (hysterectomy), requires only a small nick in the skin, through which a catheter is inserted to deliver particles that block blood flow to the fibroids. UAE may be associated with a number of days of pain and cramping. The MRgFUS procedure, which was approved by the U.S. Food and Drug Administration in 2004 as a treatment option for uterine fibroids, is noninvasive: it uses ultrasound energy to ablate the fibroids. MRgFUS is quick and painless for many, and symptom relief has been shown to occur by 12 weeks.
"In order to be widely adopted, MRgFUS must be deemed as beneficial as the established alternatives," Dr. Fennessy said. "Our study not only provides measures to aid in future cost-utility analysis of uterine fibroid treatments, but it may be helpful to patient and physician decision-making with regard to treatment options."
"Quality-of-Life Assessment of Fibroid Treatment Options and Outcomes." Collaborating with Dr. Fennessy were Chung Yin Kong, Ph.D., Clare M. Tempany, M.D., and J. Shannon Swan, M.D.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsna.org/)
RSNA is an association of more than 46,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA.org)
For patient-friendly information on UAE, visit RadiologyInfo.org.
Linda Brooks | EurekAlert!
Drone vs. truck deliveries: Which create less carbon pollution?
31.05.2017 | University of Washington
New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)
An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.
Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...
19.06.2017 | Event News
13.06.2017 | Event News
13.06.2017 | Event News
29.06.2017 | Power and Electrical Engineering
29.06.2017 | Life Sciences
29.06.2017 | Seminars Workshops