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The newspaper of The Johns Hopkins University March 21, 2005 | Vol. 34 No. 26
Uterine Fibroid Treatment and Research Are Focus of New Center

By David March
Johns Hopkins Medicine

Johns Hopkins Medicine has opened a new center for treating and investigating the causes of uterine fibroids, a medical condition that afflicts millions of American women. The center will specialize in state-of-the-art therapies for the condition and in the rapid application of new research to the treatment of these mostly benign growths of the wall of the uterus.

Fibroids, which can vary in number and range in size from as small as a pea to as large as a grapefruit or small melon, may result in excessive bleeding, anemia, infertility and excessive pressure on the bladder and bowel. An estimated one-third of the 600,000 hysterectomies performed each year in the United States are due to fibroids.

"Linking clinical practice to medical research is the best way we have of determining why fibroids affect some women and not others, and in deciding when to intervene medically or surgically," said gynecologic surgeon John Griffith, an assistant professor at the School of Medicine and director of the new Fibroid Center, which is located at Johns Hopkins facilities at Green Spring Station. "We anticipate using the vast epidemiological and genetics expertise at Hopkins to learn more about why fibroids disproportionately afflict more black American women. We also hope to be able to predict growth patterns so that there will be less of an impact on childbearing.

Johns Hopkins' research-based resources distinguish its program from others in the field, said Griffith, who will lead a team of a dozen faculty and 40 staff that includes interventional radiologists, reproductive endocrinologists, geneticists, nurses and public health experts.

On the treatment side, the Hopkins team will emphasize minimally invasive techniques that focus on removing or shrinking fibroids instead of surgically removing the entire uterus. Particular attention will be paid to preserving the uterus for women who have not completed childbearing.

The cause of fibroids is unknown, but excess estrogen is believed to play a role in their development, and hormone therapy is often used to shrink tumors.

"For benign fibroids, many women undergo hysterectomy, the most common abdominal surgery for women in the United States, said interventional radiologist Hyun Kevin Kim, an assistant professor. "Our goal is to develop and offer new, minimally invasive therapies for women."

Kim added that laparoscopic, or minimally invasive, procedures are the current trend, allowing physicians to shrink fibroids and avoid the complications, inconvenience and pain associated with open surgical options. Uterine artery embolization is one such procedure, in which tiny plastic pellets are used to block blood flow to the fibroid tumors, starving them of nutrients and oxygen. The pellets are implanted using a thin catheter threaded from the groin to the uterine arteries. Although embolization requires pain medication and an overnight hospital stay, the recovery period lasts slightly longer than one week.

Another current treatment option uses ultrasound energy to shrink fibroid tumors. Magnetic resonance imaging is used to guide the focused ultrasound therapy to fibers of the tumor. Although the procedure can require the patient to spend up to three hours in the MRI, there are no incisions or hospital stayovers.

Griffith said that the goal of the Hopkins center is to conduct evidence-based research comparing treatment to determine which procedure is best for particular women. No definitive answer to what should be done currently exists, he said, either for patients or physicians.

More information about Hopkins Fibroid Cen-ter and its services is available at


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