Women who undergo a uterus-preserving procedure to manage uterine fibroids often have to have further procedures, according to Dr. Elisa Martin-Merino of the Spanish Centre for Pharmacoepidemiologic Research in Madrid and her associates.
After 1 year, 23.6% of women aged 15-54 with uterine fibroids had a hysterectomy or uterus-preserving procedure (UPP), with the rate increasing to 40.9% at the end of the follow-up period, which was a median of 3.6 years. About one-third of all study participants underwent a hysterectomy during the study period. Myomectomy, endometrial ablation, and uterine artery embolization were much less common, performed in 3.9%, 6.4%, and 1.9% of study participants respectively.
The incidence of a repeat UPP after being initially treated with a UPP was 11.5% at 1 year, and 26.1% at the end of the study period. The cumulative incidences of women undergoing hysterectomy, myomectomy, endometrial ablation, and uterine artery embolization were 19.0%, 4.3%, 3.4%, and 1.4%, respectively.
“Women considering UPPs for the management of [uterine fibroids] should be made aware that the incidence of further treatments is high, with hysterectomy being the most frequent procedure undergone,” the investigators wrote.
Find the full study in the European Journal of Obstetrics & Gynecology and Reproductive Biology ( doi: 10.1016/j.ejogrb.2015.08.034 ).
