Uterine Fibroid Embolization (UFE)
703-504-7950
What Are Uterine Fibroids?
Uterine fibroids are noncancerous (benign) growths on or within the
muscular walls of the uterus. They can be as small as a pea, or as large
as a cantaloupe. Women may develop any of three primary types of uterine
fibroids in various parts of the uterus:
- Intramural fibroids are the
most common. They develop within the lining of the uterus
and expand inward. They make the uterus feel larger than normal and often cause heavy
menstrual bleeding, pelvic pain, back pain or urinary frequency.
- Subserosal fibroids develop under the outside covering
of the uterus and expand
through the wall, giving the uterus a knobby appearance. They can cause pelvic pain and
back pain.
- Submucosal fibroids are the least common type. They develop just under the lining of the uterus. Even small ones can cause heavy and prolonged periods.
Image reprinted with permission of Society of Interventional Radiology and ©2004.
What Are the Symptoms?
Some women may not know that they have fibroids, while others experience
symptoms, such as pain, heavy bleeding or abdominal swelling. The symptoms
depend on the size and location of the fibroid, but may include one or more
of the following:
- heavy, prolonged menstrual periods, sometimes with clots
- pelvic pain, pressure or heaviness
- pain in the back or legs
- pressure on the bladder causing a constant urge to urinate
- pressure on the bowel causing constipation and bloating
- abnormally enlarged abdomen
Who Is Most Likely to Have Uterine Fibroids?
Approximately 20 to 40 percent of women age 35 and older have uterine
fibroids. African American women are at higher risk and as many as 50
percent have fibroids.
How Are Uterine Fibroids Diagnosed?
Most fibroids are diagnosed when a physician feels an enlarged uterus during
an internal gynecologic exam. Fibroids can be confirmed by an abdominal ultrasound,
magnetic resonance (MRI) or computed tomography (CT), all of which are painless
diagnostic procedures.
Treatment Options
How Are Uterine Fibroids Treated?
Most fibroids do not cause symptoms and are not treated. When they do
cause symptoms, the first line of treatment is usually drug therapy. Birth
control pills or other hormone therapy may be prescribed, along with nonsteroidal
anti-inflammatory drugs
(NSAIDs) such as ibuprofen or naproxen sodium.
If symptoms persist, your physician can help you decide which treatment is best for you based on your medical history, the location and size of the fibroids, and the severity of your symptoms. Your options may include the following:
- Myomectomy removes only the fibroids, not the uterus. This surgery
is performed using a hysteroscope (a small scope inserted through the
vagina and cervix), a laparoscope (a scope inserted through small incisions
in the abdomen), or abdominal surgery (requiring incisions through the
abdomen and the uterus).
- Hysterectomy removes the entire uterus either by a laparoscopic
procedure through the vagina, or by an open surgical procedure. Uterine
fibroids are the most common cause of hysterectomy in the country.
Either of these surgical procedures requires a six-week recovery period.
- Uterine fibroid embolization (UFE), also known as uterine artery embolization, is an alternative to surgery that preserves the uterus .A non-surgical, minimally invasive procedure, UFE blocks the blood supply to fibroids, causing them to shrink.
Uterine Fibroid Embolization (UFE)
How Is UFE Performed?
UFE is performed by an interventional radiologist ? a doctor specializing
in the use of imaging techniques to see inside the body and treat conditions
without surgery.
During UFE, the patient is given pain medications but remains awake. The interventional radiologist inserts a small tube, called a catheter, through a tiny incision in the skin, less than a quarter of an inch, into an artery at the top of the thigh. Using X-ray imaging, the catheter is guided into the uterine artery. Then tiny, round particles, the size of grains of sand, are injected through the catheter into the blood vessels leading to the fibroids. These particles cut off the blood supply to the fibroid. This process is repeated in the other uterine artery, completely blocking the blood flow feeding the fibroid. Blocking the blood flow to the fibroids causes them to shrink and alleviates symptoms. The particles remain permanently in the blood vessels at the fibroid sites, and cannot travel to other parts of the body. The procedure typically takes less than one hour to complete.
Click
on image
for larger view.
Image courtesy of BioSphere Medical, Inc.
What Happens After the Procedure?
Typically, patients stay in the hospital over night. Shortly after the
procedure, most women experience abdominal cramping similar to menstrual
cramps, or nausea. During the hospitalization, the patient receives medications
to control these common side effects. By the morning after the procedure,
these symptoms are usually gone. At home, the patient will likely have
several days of intermittent cramps, and may feel somewhat weak. These
symptoms usually begin to resolve within several days and most patients
will fully recover in seven to 10 days.
How Successful Is UFE?
Approximately nine women out of 10 who have this procedure experience
significant or total relief of heavy bleeding, pain and other symptoms.
The procedure is effective for multiple fibroids, and the recurrence of
treated fibroids is very rare.
Is This a Safe Procedure?
Fibroid embolization is considered a very safe procedure. For more than
20 years, interventional radiologists have used embolization in the uterus
to treat heavy bleeding following childbirth. Embolization has been used
since 1995 to treat fibroids. All devices, equipment and medications used
for fibroid embolization are FDA approved. However, as with any medical
procedure, there are risks. There is about a one percent chance of injury
to the uterus. You should talk with your doctor about the possible side
effects of any procedure you may choose.
How Will UFE Affect My Fertility?
By preserving the uterus, women may have an opportunity for future pregnancy,
but the full affect of UFE on fertility has not been evaluated. Our interventional
radiologists are actively conducting research on this aspect of UFE treatment.
