The Great Myomectomy Scandal

Gynaecologists withholding information on myomectomy patients of recurrence rates.

Recurrence Rates after Myomectomy

Recently, in the United States, the Society of Interventional Radiology (SIR) carried out a nationwide poll, conducted by Harris, in which they surveyed 1,176 US women above the age of 18 to determine their knowledge of fibroid treatment options. The survey found that 46% of women diagnosed with uterine fibroids who had heard of UFE did not learn about the treatment from their Gynaecologist. To quote Professor James Spies, past President of Society of Interventional Radiology, a Professor of Radiology at Georgetown University Medical Centre and advisor: “Misconceptions about uterine fibroids and their treatment and the treatment available often leaves women to undergo invasive, potentially unnecessary, surgery for their fibroids despite more than 20 years of clinical use supporting Fibroid Embolisation.

The survey found that the majority of women had never heard of UFE with 44% of women diagnosed with uterine fibroids reporting that they had never heard of the treatment. In women who had heard of UFE the majority, 73%, did not learn about it from their gynaecologist.

We conducted a small trial in the UK of 100 of our patients and and found that 25% had not heard about Fibroid Embolisation from their Gynaecologist. This is, however, a highly selective group in which you would expect that percentage to be very much lower.

The conclusion of this is that patients in the United States and the United Kingdom are regularly not being told about Fibroid Embolisation by their Gynaecologist. From our own experience, in some cases they are also sometimes given misleading information by their Gynaecologist.

The big advantage of embolisation over myomectomy in patients with multiple fibroids is that in the overwhelming majority of cases, all the fibroids will be killed at one hit; in other words, once the fibroids are dead, the patient’s situation can only improve. Recurrence rates are extremely low with fibroid embolisation.

This is not the case with myomectomy: the recurrence rate after myomectomy is around 75% and within 5 years 25% of patients who have myomectomies will come to further major surgery and this is usually a hysterectomy. Obviously, since you are looking at a 25% hysterectomy rate approximately after myomectomy, patients should be told about this but they are not told of this major difference between embolisation and myomectomy. They are also often not told of the full list of complications that can occur with both open myomectomy and laparoscopic myomectomy where the complication list is very similar.