ACR Appropriateness Criteria ® on Treatment of Uterine Leiomyomas

• Published in: Journal of the American College of Radiology Vol. 8; no. 4; pp. 228 - 234
• Main Authors: Burke, Charles T., MD, Funaki, Brian S., MD, Ray, Charles E., MD, Kinney, Thomas B., MD, Kostelic, Jon K., MD, Loesberg, Andrew, MD, Lorenz, Jonathan M., MD, Millward, Steven F., MD, Nemcek, Albert A., MD, Owens, Charles A., MD, Shaw, Howard, MD, Silberzweig, James E., MD, Vatakencherry, George, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2011
• Subjects: Appropriateness Criteria; Catheter Ablation; Contraceptives, Oral - therapeutic use; Cost-Benefit Analysis; Evidence-Based Medicine; Female; Humans; Hysterectomy; Laparoscopy; Leiomyoma - surgery; Leiomyoma - therapy; myomectomy; Radiology; Radiology, Interventional; Ultrasonic Therapy; United States; uterine artery embolization; Uterine Artery Embolization - methods; uterine fibroids; uterine leiomyoma; Uterine Neoplasms - surgery; Uterine Neoplasms - therapy; Uterus - blood supply; United States; uterine fibroids; myomectomy; uterine leiomyoma; Appropriateness Criteria; uterine artery embolization; hysterectomy
• ISSN: 1546-1440; 1558-349X
• DOI: 10.1016/j.jacr.2010.12.020

Uterine leiomyomas (fibroids) are the most common tumors in women of reproductive age and a cause of significant morbidity in this patient population. Depending on the fibroid location, they can be the cause of a variety of symptoms, such as abnormal uterine bleeding, constipation, urinary frequency, and pain. Historically, hysterectomy has been the primary treatment option, and uterine fibroids remain the leading cause for hysterectomy in the United States. However, women who do not wish to undergo hysterectomy now have a variety of less invasive options available, including uterine artery embolization. This article discusses uterine artery embolization as well as some of the other treatment strategies for symptomatic uterine fibroids. In many situations, there may be no single best treatment option but several viable alternatives. Each option is discussed with consideration of outcomes, complications, and, when possible, cost-effectiveness. The recommendations in this article are the result of evidence-based consensus of the ACR Appropriateness Criteria ® Expert Panel on Interventional Radiology.