In a two-part study, researchers at Yale have found most women will change doctors if their gynecologists do not support their decision to have uterine fibroids treated in a minimally invasive procedure performed by interventional radiologists.
The study showed that 89% of women will switch from gynecologists who don't advocate treatment of their fibroids using Uterine Fibroid Embolization (UFE). Results of the study were presented at the recent Society of Cardiovascular and Interventional Radiology Annual Conference.
"We're finding that women are really taking charge of their own destinies and are not totally depending on their gynecologists' opinion," says Dr. Michael Wysoki, clinical assistant professor of diagnostic radiology at the School of Medicine. "The Internet has made the greatest difference, with women doing quite a bit of research online as they explore alternative treatments for fibroids."
Fibroids are non-cancerous growths in the uterus that can cause pain, heavy bleeding and pressure in the abdomen. They are often treated with hysterectomy, which can have a significant impact on general health and well-being, and ends a woman's ability to have children. UFE is a less invasive treatment in which a small incision is made in the groin area and a catheter is inserted into the femoral artery and guided to the uterus using a moving X-ray, or fluoroscope. The blood supply to the fibroid is then cut off using small gelatinous particles that are injected into the vessels.
In the first part of the study, Wysoki and his team studied 21 women who had UFE and found that 19 of them had to initiate a conversation about UFE with their gynecologists. All of the gynecologists initially recommended hysterectomy. Nine women reported that their gynecologists opposed UFE and eight of those women (89%) are now seeing other gynecologists. Only five of the women found their gynecologists to have a favorable opinion toward UFE. Sixteen women said their gynecologists were opposed or strongly opposed to the procedure. Of those opposed, seven (44%) changed their minds and were indifferent or favorable after the patients had UFE.
Wysoki says one of the many reasons some gynecologists are opposed to UFE is that they do not perform the procedure, and are therefore unfamiliar with its merits.
"Studies show that symptoms significantly improve in up to 90% of patients who have UFE and it is now commonly performed, with more than 8,600 procedures in the United States alone," says Wysoki.
In the second part of the study of 21 women who underwent UFE, a telephone survey revealed that 43% of the women reported an increase in sexual desire. An increase in the frequency of sexual relations was reported by 40% of the women; 60% reported less pain during intercourse and 27% reported more frequent orgasms.
"This preliminary study shows that after having UFE, women's sex lives remain intact, and may actually improve," says Wysoki. "Many women said they didn't have a great desire for sex before UFE because they felt bloated and had bleeding or pain during intercourse. More research is needed to either confirm or contradict these findings."
Other investigators on the study included Drs. Boyd P. Bird, Mel Rosenblatt, Catherine Burdge and Jeffrey Pollak of the Section of Vascular and Interventional Radiology at the Yale School of Medicine and Yale-New Haven Hospital; and Kathy Onze of the VA Connecticut Healthcare System.
-- By Karen Peart
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