Fibroids are tumors that grow in the muscular walls of the uterus. Fibroids may be as small as a pea or as large as a cantaloupe. Approximately 20%-40% of women 20 years and older will develop one or more of these uterine tumors before reaching menopause. The risk is even higher among African-American women: 50% will develop fibroids during their lifetimes. The good news is that fibroids are usually not cancerous and may never produce noticeable symptoms in many women. The bad news is that unwanted symptoms will occur in 10%-20% of women with fibroids and may significantly impact the quality of life for these women, depending on the location, size and number of uterine tumors.
Common symptoms include:
- Very heavy or long menstrual periods, sometimes with blood clotting
- Increased menstrual cramps
- Pain, pressure or discomfort in the pelvis
Pain in the leg or lower back
- Pain during sexual intercourse
- Frequent trips to the bathroom, caused by pressure on the bladder
- Constipation
- Bloating
- An abnormally large abdomen, which may be misinterpreted as weight gain or imitate the appearance of pregnancy
While many women begin to develop uterine fibroids in their 20s, symptoms usually do not occur until women reach their late 30s or early 40s. In the early stages of development, physicians are unable to predict if fibroids will increase in size, multiply, or shift to a place in the uterus that will cause symptoms severe enough to require medical treatment. However, fibroids that produce symptoms trigger the need for approximately 150,000 hysterectomies each year, which is one-third of all hysterectomies performed in the U.S. So far, medical researchers are unable to explain why some women develop uterine fibroids while others do not, but they believe genetics play a significant role.
Uterine Artery Embolization Offers Women a Non-Surgical Alternative
In the past, treatment of uterine fibroids has been limited to surgery, either hysterectomy (removal of the uterus) or myomectomy (removal of the fibroid). A hysterectomy requires 3-4 days of hospitalization as well as 4-6 weeks of recovery. A myomectomy often causes pelvic scarring, which may complicate future surgery. Additionally, fibroids develop again in 10-30% of myomectomy patients. During the past several years, uterine artery embolization (UAE) has emerged as a safe and highly effective treatment for fibroids. UAE employs the same non-surgical, minimally-invasive techniques that interventional radiologists have been using for 20 years to control pelvic bleeding. Thousands of procedures have been successfully performed worldwide, and UAE is now widely accepted in the U.S. and in Europe as a successful alternative to surgery.
Benefits of UAE
- Avoid the risks of surgery and general anesthesia
- Rapid recovery
- Fewer complications
- 78%-94% clinical success rate with no further therapy required
- Reduces fibroid size by approximately ½ and facilitates further treatment, when necessary
What to Expect From Fibroid Embolization
Before the procedure…
Before embolization, a physician performs a complete medical history and physical examination including pertinent lab tests. A MRI of the pelvis is also obtained to clearly show the size and position of the fibroids in the uterus, and to help the physician rule out other conditions for which UAE would not be appropriate. UAE is covered by most health insurance plans. However, most managed care insurance companies, such as Preferred Provider Organizations (PPOs), health maintenance organizations (HMOs) and Point of Service Plans (POSs), require a referral or authorization from a primary care physician prior to approving reimbursement for specialty care.
During the procedure…
The embolization is performed through a small puncture in a groin artery. X-ray dye is injected into the artery to identify which blood vessels supply the uterus and fibroids. The radiologist guides a wire and catheter into these vessels, and injects very small particles. These particles block the blood supply to the fibroids, causing them to shrink over time.
After the procedure…
Menstrual cramp-like pain can be expected after the procedure. The patient is usually hospitalized overnight so that intravenous pain medication can be given. By the following day, pain can usually be controlled with oral pain medications. Symptoms will gradually improve, and patients return to normal activity within one week. Follow-up visits or phone calls are scheduled for one week, one month, three months and six months after the procedure. The fibroids and the uterus usually shrink to approximately one half their pre-procedure size.
For more information on UAE procedures, contact:
Farah Williams, MD
Cascade Radiology Consultants, PC
Department of Interventional Radiology
Phone 404-466-1508 |
