Fibroids are the most common benign tumors in women of reproductive age, occurring in up to 80% of the population, with 20-50% of those requiring clinical intervention. Most common symptoms are: excessive and irregular bleeding, anaemia, pelvic pain, bowel and bladder dysfunction, and pain during intercourse. Up to now, fibroid surgery (hysterectomy, (laparoscopic) myomectomy or uterine artery embolization (UAE)) is the gold standard, but not always preferable. Ulipristal acetate (UPA) was introduced in 2012 as a new treatment option for symptomatic uterine fibroids. UPA is a selective progesterone receptor modulator with effect on fibroid volume and fibroid related complaints and might have the potential to prevent surgery.
The MYOMEX-2 study compares UPA with standard surgery to investigate the (cost-) effectiveness and symptom reduction in patients with moderate to severe complaints due to uterine fibroids. Both treatment strategies are current clinical practice in the Netherlands.