Northwestern Medicine to focus on fibroids
Posted by on October 11, 2014 - 11:36am

Uterine fibroids are the most common noncancerous tumors in women of childbearing age and the second most common reason these women undergo surgery. Uterine fibroids can lead to significant pain, bleeding, and fertility problems. Treatment options include watchful waiting; treatment with drugs or hormones, embolization, or ultrasound; and invasive procedures such as partial or total hysterectomy. However, there is little evidence about the effectiveness of these therapies or their outcomes, including fibroid reoccurrence and women’s ability to have children.

Northwestern Medicine will be one of ten investigational sites for a landmark study that seeks to improve the way uterine fibroids, one of the most prevalent health issues impacting women, are treated.

Erica E. Marsh, MD, a reproductive endocrinologist with Northwestern Fertility and Reproductive Medicine, serves as the principal investigator for Northwestern’s portion of the $20 million research project, which evaluates the effectiveness of different treatment strategies for women with uterine fibroids by building a national database tracking patients, treatments and outcomes.

“Right now there’s very, very little clinical trial data on fibroid outcomes,” said Marsh, who is also an assistant professor of Obstetrics and Gynecology-Reproductive Endocrinology & Infertility at Northwestern University Feinberg School of Medicine. “This type of study with a huge sample size in the thousands across the nation will allow us to start to tease apart some of those questions we’ve always asked ourselves as physicians who take care of women with fibroids. What can I tell my patients about the risk of occurrence after one treatment versus another? The impact on fertility? The likelihood that her symptoms will return? Having this type of outcomes data will allow us to answer some of those questions.”

Safety issues with laparoscopic uterine/fibroid procedure
Posted by on April 17, 2014 - 11:38am

Today, FDA issued a safety communication discouraging the use of laparoscopic power morcellation for the removal of the uterus (hysterectomy) or uterine fibroids (myomectomy) in women.  This type of procedure poses a risk of spreading unsuspected cancerous tissue, notably uterine sarcomas, a type of uterine cancer.

Laparoscopic power morcellation is one of several available treatments for fibroids.  It is a procedure that uses a medical device to divide the uterine tissue into smaller pieces so it can be removed through a small incision in the abdomen.  Prior to treatment, there is no reliable method for identifying whether a woman may have an unsuspected uterine sarcoma instead of, or in addition to, fibroids.  Published studies suggest that morcellation of an unsuspected uterine sarcoma increases the risk of cancer spread.

Most women will develop uterine fibroids at some point in their lives, and, while most uterine fibroids do not cause problems for women who have them, they can cause symptoms such as heavy or prolonged menstrual bleeding and pain, requiring medical or surgical therapy.

The FDA’s primary concern as it considers the continued use of these devices is the safety and well-being of patients, and will continue looking into this issue by convening a panel of outside experts at a public meeting to discuss the clinical role of laparoscopic power morcellation in these treatments, surgical techniques, and labeling related to these devices. Information on this meeting will be posted as soon as it becomes available.

In today’s safety communication, the FDA made specific recommendations on this topic for health care providers and women.

If you have questions about this communication, please contact the Center for Devices and Radiological Health’s Division of Industry and Consumer Education (DICE) at DICE@FDA.HHS.GOV, 800-638-2041 or 301-796-7100.

Uterine Fibroids
Posted by on November 19, 2010 - 10:25am

Uterine fibroids are the most common, non-cancerous tumors in women of childbearing age. The fibroids are made of muscle cells and other tissues that grow within and around the wall of the uterus.   See the diagram that shows where uterine fibroids may grow.

There are several risk factors for uterine fibroids:

  • African American woman are at three- to five-times greater risk than white women for fibroids.
  • Women who are overweight or obese for their height are at greater risk.
  • Women who have given birth are a lower risk.

Many women with uterine fibroids have no symptoms. Symptoms of uterine fibroids can include:

  • Heavy or painful periods, or bleeding between periods
  • Feeling “full” in the lower abdomen
  • Urinating often
  • Pain during sex
  • Lower back pain
  • Reproductive problems, such as infertility, multiple miscarriages, or early labor

Most women with fibroids do not have problems with fertility and can get pregnant. However, some women with fibroids may not be able to get pregnant naturally,  but advances in treatments for infertility may help some of these women get pregnant.

If you have uterine fibroids, but show no symptoms, you many not need any treatment.  Women who have pain and other symptoms might benefit from treatment which includes medication and/or surgery.   Medications can offer relief from the symptoms of fibroids and even slow or stop their growth. But, once you stop taking the medicine, the fibroids often grow back. There are several types of fibroid surgery:

  • Myomectomy – Removes only the fibroids and leaves the healthy areas of the uterus in place
  • Uterine Artery Embolization (UAE) – Cuts off the blood supply to the uterus and fibroids, making them shrink
  • Hysterectomy - A more major procedure that removes the uterus; this type of surgery is the only sure way to cure fibroids.

For more details about treatments for fibroids, see the free booklet from the NICHD.

In addition, if you have fibroids and need support, the Fibroids Project is a one-stop shop for women with uterine fibroids created by a women with who has been there.