Uterine Fibroid Embolization, a minimally invasive treatment for fibroids, is a safe and highly effective option for women to consider and often replaces the need for a hysterectomy.
GCM Radiology uses advanced interventional radiologic techniques in the treatment of uterine fibroids. Uterine fibroids are benign tumors that form in the muscular wall of the uterus (Figure 1).
Studies have not yet revealed how uterine fibroids start, but genetics and hormones are thought to contribute to their development.
The Society of Interventional Radiology reports that 20 to 40 percent of women age 35 and older, develop uterine fibroids of a significant size. Fibroids may quit growing among postmenopausal women, but have been shown to continue growing among postmenopausal women who are on estrogen replacement therapy. While most fibroids do not cause any symptoms or discomfort, 10 to 20 percent of women who develop fibroids require treatment for a variety of symptoms that can include prolonged, heavy menstrual periods and accompanying anemia; pelvic, leg, and back pain; a constant urge to urinate; distended abdomen; pain during intercourse; and constipation.
Traditionally, uterine fibroids have been treated surgically, either with hysterectomy (removal of the uterus) or with myomectomy (removal of the fibroids, or myomas). Approximately one of every three hysterectomies performed is for the treatment of uterine fibroids. Full open surgery requires a hospital stay of three to four days, followed by a six-week recovery period. Laparoscopic surgeries, performed through small incisions with visualization provided by surgical cameras, have shorter hospitalization and recovery times, but patients should remember that these are still surgical procedures and should follow their doctors' recommendations during their recovery period.
A Less Invasive Option
Interventional radiology offers a significantly less invasive approach to the treatment of uterine fibroids: Uterine Fibroid Embolization (UFE), also known as Uterine Artery Embolization (UAE). GCM physicians have performed this and very similar procedures thousands of times, with exceptional results.
Am I a candidate for UFE?
Our typical patient is very active, and generally between 35 and 50 years of age, although we do see both younger and older patients. Whatever her age, she is very concerned about the recovery time and/or potential side effects or complications related to surgical hysterectomy, and is not interested in becoming pregnant. While successful pregnancies have been reported following UFE, women desiring successful pregnancies are encouraged to first pursue surgical myomectomy when appropriate. UFE can successfully be performed following myomectomy and fibroid re-growth, when necessary.
How is the UFE procedure performed?
Prior to UFE, we may perform MRI or ultrasound imaging to provide a fuller assessment of the size, number, and location of the fibroids. Additionally, if bleeding is a significant symptom, a biopsy of the endometrium may be performed to rule out the presence of cancer.
The UFE procedure itself takes about 30 minutes to perform, and usually requires one overnight stay in the hospital. Approximately 90 percent of patients treated with UFE experience complete or near complete relief of their related symptoms, and return to work within a week.
UFE involves the placement of a very small puncture in the groin (Figure 2). This incision serves as the portal for introducing small plastic tubes (catheters) to the surgery site.
Using fluoroscopic guidance, the interventional radiologist introduces a delicate catheter into the arteries supplying the uterus, and then injects small, harmless embolic particles no larger than a grain of sand into those arteries, effectively reducing the blood supply to the fibroids (Figure 3). Deprived of blood, the fibroids shrink, resulting in a reduction or complete elimination of symptoms (Figures 4 and 5). The catheter is removed at the end of the procedure, and a small, dissolving collagen plug is typically left under the skin at the puncture site.
Will it hurt?
Discomfort during the UFE procedure is minimal. Following the procedure, there may be some discomfort, which will peak about 3 hours after the procedure, and this can be easily controlled with pain-relieving medications. Most discomfort is gone by the next morning, and virtually all patients are released from the hospital within 24 hours after their procedure, requiring only ibuprofen or, in some cases, Percocet®, for comfort.
Scheduling a Consultation
Patients may schedule a consultation to speak with an Interventional Radiologist about this procedure. Any studies, such an ultrasound or MRI, which have been previously performed should be brought to the appointment if possible. During the appointment, the procedure and any necessary pre-procedure imaging studies can be scheduled.
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