Practice Advisory: Management of Uterine Leiomyomas (Fibroids)

On December 14, 2017, the Agency for Healthcare Research and Quality (AHRQ) released a comparative effectiveness review on the management of uterine fibroids (1). The AHRQ’s systematic review of the literature includes analysis of randomized control trial data on the effectiveness of interventions for reducing leiomyoma size and improving a patient’s symptoms and quality of life. The report also includes data on the risk of encountering a leiomyosarcoma at the time of surgery for presumed leiomyomas.

In December 2017, the U.S. Food and Drug Administration’s (FDA) Center for Devices and Radiological Health released the “FDA Updated Assessment of The Use of Laparoscopic Power Morcellators to Treat Uterine Fibroids” (2). The FDA’s assessment includes a total of 23 studies as well as Medical Device Reports submitted to the FDA.

The American College of Obstetricians and Gynecologists (ACOG) is evaluating these evidence reviews to determine the need to update ACOG guidance on the medical and surgical management of leiomyomas. When available, any new guidance will be published in Obstetrics & Gynecology and on the ACOG website.

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1. Hartmann KE, Fonnesbeck C, Surawicz T, Krishnaswami S, Andrews JC, Wilson JE, et al. Management of uterine fibroids. Comparative Effectiveness Review No. 195. Rockville (MD): Agency for Healthcare Research and Quality; 2017. Available at: Retrieved December 14, 2017.

2. Food and Drug Administration. FDA updated assessment of the use of laparoscopic power morcellators to treat uterine fibroids. Silver Spring (MD): FDA; 2017. Available at: Retrieved December 14, 2017.


A Practice Advisory is issued when information on an emergent clinical issue (e.g. clinical study, scientific report, draft regulation) is released that requires an immediate or rapid response, particularly if it is anticipated that it will generate a multitude of inquiries. A Practice Advisory is a brief, focused statement issued within 24-48 hours of the release of this evolving information and constitutes ACOG clinical guidance. A Practice Advisory is issued only on-line for Fellows but may also be used by patients and the media. Practice Advisories are reviewed periodically for reaffirmation, revision, withdrawal or incorporation into other ACOG guidelines.

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The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation's leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 57,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization.

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