As reported in the Daily Mail on Thursday, June 1st 2017, Fern Britton revealed that she was “resigned to dying” when she developed sepsis following a hysterectomy for fibroids. Three days after the operation she developed agonising pain and was re-admitted to hospital. A severe infection with several abscesses in the pelvis was identified. In addition the infection had caused a septicaemia, i.e. she had an infection in her blood stream which then attacked multiple organs. She went on to develop pneumonia and a collapsed lung. She required emergency surgery to deal with the abscesses in her pelvis.
Frankly, her experience sounds pretty horrific. We have to ask the question: Was she given the option of fibroid embolisation by her gynaecologist? All the papers comparing hysterectomy or myomectomy (individual removal of fibroids) with fibroid embolisation show fibroid embolisation to have a much lower complication rate. The incidence of sepsis from fibroid embolisation resulting in emergency hysterectomy is extremely rare. We have had none in our last 1,700 cases. In the early days of fibroid embolisation the incidence was somewhat higher, probably related to over-embolisation due to poor technique. Overall hysterectomy for fibroids carries a serious complication rate of 4-6%. This includes sepsis, abscess formation in the pelvis, cutting the bowel, the bladder, the ureter, often requiring further major surgery, wound dehiscence, keloid formation, vaginal prolapse, delayed bowel obstruction from adhesions and many others. The list is very extensive.
There is a 1 in 900 death rate, mainly from DVT and pulmonary embolus. The complications of fibroid embolisation are infection leading to hysterectomy which, as explained above, is extremely rare, and ovarian failure with premature menopause, again this event under the age of 45 is rare with a rate given on 0.5%. In our practice I cannot think of such an event in many hundreds of patients under 45 that I have treated and I believe that ovarian failure rate may be due in some cases to poor technique in performing the fibroid embolisation.
The message of this post is that every woman should be fully informed by her gynaecologist and given the option of fibroid embolisation. Virtually all types and numbers of fibroids are suitable for fibroid embolisation. It is very unusual for a woman to be unsuitable for this procedure. Fibroid embolisation is recommended by NICE, The American College of Obstetrics & Gynaecologist and has been an 'A' rating on the NHS. It was passed by NICE in 2007.