Less blood, better outcomes: Combination treatment for women with fibroids

They impact 80 percent of women and disproportionately impact women of color. Fibroids are benign tumors that grow in the uterus. But removing the lesions puts patients at risk for serious complications. A Chicago area doctor sought a better, safer treatment and it’s making a measurable difference.

“Initially I was told have a full hysterectomy which I was surprised by,” patient Angela Lamondi said.

That was one option the 41-year-old had after an MRI scan revealed several large fibroids that were causing daily pain and pressure and compromising her bladder function.

“I was next told that all of the fibroids could just be cut out, which ran the risk of extreme blood loss and then a possible blood transfusion would be needed,” she said. “I went with my gut. It just seemed I was too young to have to do something so invasive. So I’m glad I looked for other options.”

Dr Magdy Milad had another plan.

To reduce blood loss and preserve the uterus, the Northwestern Medicine ob-gyn offered a combination of treatments.

First, interventional radiologists cut off the blood supply to the fibroids – a procedure called uterine artery embolization that’s been used since the ‘90s.

The second step was surgery for Lamondi on the same day. Called a myomectomy, Milad removed as many fibroids as possible with much less blood loss thanks to the earlier embolization.

“In a lot of cases we can minimize blood loss to just a couple of tablespoons,” Milad said.

What can be a 200 to 800 milliliter-loss in blood during a typical myomectomy was reduced to about 15 mls in Lamondi combination case. The team also used several medications and a tourniquet around the uterus to control bleeding.

“There are alternatives and it’s just a matter of going to somebody with a lot of experience,” Milad said

“I have a great reduction in pain. And I got to keep my uterus,” Lamondi said.

Milad says the rate of recurrence is about 15 percent with traditional methods alone and likely lower with the combination treatment.