Uterine Fibroids
Fibroids are benign uterine tumors of smooth-muscle origin. Solitary or multiple, uterine fibroids can be asymptomatic or associated with symptoms, which depend on fibroid size and location. Fibroids that remain mostly in the myometrium or grow toward the outside are usually associated with bulk-related symptoms (eg, pelvic pressure, heaviness, or discomfort; abdominal bloating). Those that grow toward the uterine cavity are mainly detected when evaluation is done for bleeding anomalies.[1]
Medical, radiologic, and surgical treatments are used in the management of uterine fibroids.[2,3,4] Surgical treatments are either definitive and involve the removal of the entire uterus, or are uterine-sparing and involve the removal of the myomas only. Uterine-sparing procedures are considered primarily for women who wish to maintain fertility.
Radiologic interventions, such as uterine artery embolization (UAE), radiofrequency ablation (RFA), cryoablation, and high-intensity focused ultrasound (HIFU), may be attractive because they are noninvasive or minimally invasive. Conservative treatment approaches are associated with recurrence risk, but we lack data on the relative risks associated with different uterine-sparing approaches.
Management Approach and Reintervention Risk
A recent systematic review and meta-analysis[5] compared the reintervention risk for recurrence and quality-of-life outcomes with the various uterine-sparing approaches. Sandberg and colleagues[5]analyzed data from 85 randomized controlled trials or cohort studies.
