Many women who have uterine fibroids go through their days with no noticeable symptoms. They may even be unaware they have fibroids at all. However, for a small percentage, daily life can be significantly impacted by symptoms.
Uterine fibroids are non-cancerous growths that occur in the wall of the uterus. They may be as small as a pea or as large as a cantaloupe. They can cause a host of disruptive symptoms: unusually heavy or long menstrual periods, pressure on the bladder leading to frequent trips to the bathroom, bloating, pain during sexual intercourse and pain in the pelvis, legs, or lower back. Uterine fibroids are common and affect 20% to 40% of women 20 years or older and occur in half of African American women. So far, doctors have been unable to pinpoint why fibroids are more common in African Americans or why women develop them at all. What we do know is that heredity and obesity are risk factors and that hormone levels play a role.
Traditionally, treatment for women with problematic uterine fibroids has been surgical— hysterectomy or myomectomy (surgical removal of the fibroids after a uterine evaluation from a gynecologist). In fact, unwanted fibroid symptoms trigger approximately 200,000 hysterectomies each year.
For close to 20 years, interventional radiologists, myself included, have used a nonsurgical alternative to treat women who suffer with uterine fibroids. This minimally invasive procedure is called embolization. The technique itself is not new, but its application to fibroids is. For more than three decades, physicians have used embolization to treat pelvic bleeding due to other causes (trauma, tumors, surgical complications). Embolization has proven to be an effective means to shrink uterine fibroids and alleviate the symptoms they cause.
Throughout my years of practice, most women who have come to me seeking information on uterine fibroid embolization have come on their own looking for an alternative to surgery. However, most women who are offered a hysterectomy do not know that there is less invasive solution.
In fact, compared to the surgical options, embolization results in fewer complications, a shorter hospital stay and a far quicker recovery time. It has an 85% to 92% success rate compared with myomectomy — 10% to 30% of myomectomy patients develop fibroids again. Long term data now shows that about 75% of women who have uterine fibroid embolization report ongoing satisfaction and continuous symptomatic relief for 5-7 years following the procedure. In fact, most women I treat report a significant improvement in their symptoms at their first post procedure check-up.
An embolization is performed through a small puncture in a groin artery. Dye is injected into the artery to identify which blood vessels supply the uterus and fibroids. The interventional radiologist then guides a wire and catheter into the identified vessels and injects small particles that block the blood supply to the fibroids. The fibroids and the uterus shrink approximately 50-60% in the first year. Heavy periods usually take a few cycles to lessen. The procedure takes approximately an hour followed by a day’s stay in the hospital for intravenous pain medication. Patients can usually resume normal activity after a week.
If you have additional questions about uterine fibroid embolization, please join Roger Williams, DO, and me as we host a free live web chat on the topic of UFE on June 13, 2012 (12:30 p.m. EST). Bring your questions and get ready for a great discussion!
About the Author
Gail Peters, M.D. is an Assistant Professor of Radiology at Emory University Hospital and Emory University Hospital Midtown. Dr. Peters’ specialties are in Interventional Radiology, Pediatric Radiology with clinical interests in Fibroid Embolization.