Fibroid Treatment: Uterine Fibroid Embolization
More than 5 million women in the U.S. have symptomatic fibroids, yet only 300,000 of them have surgery each year. That means there are millions of women living uncomfortably with symptoms—often because they believe surgery is their only option after medical therapy. Uterine Fibroid Embolization (UFE) offers a new alternative, a nonsurgical therapy performed by VIRA’s interventional radiologists to effectively shrink and treat uterine fibroids. VIRA’s interventional radiologists (IR’s) will coordinate closely with your Ob-Gyn to explore whether you are a candidate for UFE which goes straight to the root of the fibroid problem without surgery. Schedule your appointment to talk with one of VIRA’s physicians now.
Pamela, a patient of VIRA’s Dr. Tarak Patel, suffered with anemia because of her heavy menstrual periods. She was told a hysterectomy was required and had even scheduled the procedure and then an ob-gyn told her about UFE and Dr. Patel:
“With Fibroids you may not have to have major surgery like a hysterectomy. Look into UFE if possible. There’s REALLY no pain involved other than some cramping afterwards. And the down time is really short compared to a hysterectomy: no more than 7 days and you’re back at it. I think Dr. Patel was very professional and that he really does care about his patients.”
Pamela of Macon, Patient of VIRA’s Dr. Tarak Patel
What are fibroids?
Uterine fibroids are benign (noncancerous) growths that grow on or within the muscle tissue of the uterus. They can range from less than an inch around to more than six inches. Approximately 20-40% of women over the age of 35 will develop fibroids, some without symptoms. Up to 80% of African American women will eventually develop fibroids. Depending upon the size and location of the fibroids within the uterus, fibroid symptoms can significantly impact a woman’s quality of life.
Symptoms of Fibroids
Women aged 35-54 potentially face an increased risk for uterine fibroid tumors. Most fibroids cause no symptoms and are only discovered when a woman has a routine pelvic examination. If you do experience fibroid symptoms, they may include:
Depending upon the size and location of the fibroid tumors within the uterus, women may experience different symptoms or no symptoms at all.
- Heavy, prolonged monthly periods, sometimes with clots.
- Anemia (fatigue due to low red blood count)
- Pressure on the bladder leading to frequent urination or incontinence
- Pain during sexual intercourse
- Pressure on bowel leading to constipation
- An enlarged belly
- Pain and pressure sensation in pelvis
- Back and/or leg pain.
If you suspect you have fibroids, your doctor should conduct an ultrasound or other imaging tests to be certain. VIRA’s physicians and staff are always available to answer your questions—just reach out to us here.
Fibroid Treatment Options
Hysterectomy (surgical removal of the uterus) for decades has been the traditional treatment for women with significant symptoms related to fibroids who no longer desire children. However, some women may prefer an option that preserves their ability to have children. Additionally a hysterectomy is considered major abdominal surgery and may require days of hospitalization and weeks of recovery time. Although rare, hysterectomy may result in post-operative complications or even death.
Myomectomy is a second surgical option which involves cutting out one or more of the fibroids. Myomectomy may be a good option depending upon the size, number, and location of the fibroid tumors, but does not get to the root of the problem. The more fibroids present, the less successful the myomectomy surgery which occasionally may result in a hysterectomy. Depending upon extent of the surgery, recovery time can be days or weeks. Like uterine fibroid embolization, a myomectomy can preserve the woman’s ability to have future pregnancy.
Endometrial Ablation is sometimes suggested by physicians, which may cause confusion as it sounds similar to “fibroid embolization” (or UFE). Endometrial ablation only treats the endometrial lining and not specifically fibroids. Endometrial ablation is best performed for women without fibroids who are suffering with heaving bleeding for other reasons and do not desire future fertility.
Medical Therapies. Nonsurgical options for control of some symptoms associated with fibroids include use of birth control pills to control excessive bleeding, non-steroidal anti-inflammatory medication (NSAID) for pain control and so-called GnRH agonists. GnRH agonists decrease estrogen production from the ovaries and can temporarily decrease fibroid size. They usually are not prescribed for more than six months, after which symptoms can recur.
Uterine fibroid embolization, a major advance for women’s health, is a relatively new but proven nonsurgical technique which preserves the uterus but reduces fibroid size.
Uterine Fibroid Embolization
Uterine fibroid embolization (UFE), also known as uterine artery embolization (UAE), is a minimally invasive option that preserves the uterus and greatly reduces recovery times compared to surgical procedures. UFE blocks the blood supply to fibroids, causing them to shrink. About 85-90% of women have significant relief or total resolution of fibroid symptoms such as heavy bleeding, pain or pressure, and other fibroid-related problems. Recurrence of fibroids following UFE is rare.
UFE is performed by an interventional radiologist (IR), a doctor who uses X-rays and other imaging techniques to see inside the body and treat conditions without surgery. During UFE the patient is conscious during the procedure but is sedated so she does not feel any pain. The IR inserts a thin tube through a tiny nick in the skin of the groin. The small tube (catheter) is placed into the femoral artery and tiny microscopic particles (Embospheres®) are injected into the uterine arteries supplying blood to the uterus and to the fibroids. The tiny particles injected into the arteries supplying the uterus starve the fibroids of the nutrients they need to grow. Over the next several months, the fibroids shrink and die.
The uterine fibroid embolization procedure generally takes about an hour in the interventional radiology room. When required, hospital stay is usually only one night during which the patient will receive pain medication and other drugs to treat any pain and cramping associated with the procedure. The patient is discharged with pain and anti-inflammatory medications. Most women resume light activity within a few days and return to work in 7 to 10 days.
Patient who are an ideal candidate for UFE include women who:
- Have symptomatic fibroids
- Do not intent to get pregnant in the future
- Want to keep their uterus
- Do not want surgery
- Want a faster recovery time
- May not be a good candidate for surgery.
While there are reports of women becoming pregnant after uterine fibroid embolization (UFE) and having successful pregnancies, there are no scientific study results establishing the safety of UFE on fertility and pregnancy. As with any medical intervention, you should discuss the most current clinical data before deciding on the fibroid treatment that is right for you. We will be glad to schedule an appointment with one of VIRA’s interventional radiologists to determine if UFE is the best option for you.
Talk to Your Doctor About Your Treatment Options
Your doctor and you are an important team for your best health . Asking questions and being an informed patient will help ensure you get the best care.
Questions you should ask about Fibroid Treatments
- What are my surgical options and my nonsurgical options for treating my uterine fibroid tumors?
- What are the advantages, risks and benefits of each fibroid treatment?
Questions you should ask about Surgical Options:
- Do I need to have surgery? Will my ovaries be removed? If so, why? Will my cervix be removed? If so, why?
- What are the risks associated with surgery?
- Will I experience earlier menopause?
- Will I need to take hormone replacement therapy? If not, what symptoms will I experience?
Questions you should ask about UFE:
- How will you coordinate my care with my Ob-Gyn (or Interventional Radiologist-IR)?
- How often is the procedure successful in treating uterine fibroids?
- How often do complications occur? What are Typical Complications?
- How will I feel during and after the UFE Procedure?
- How long should I expect to be away from work? What is the normal recovery time?
- Will my fibroids, or the symptoms of my fibroids, come back?
VIRA is Here for YOU!
In addition to VIRA’s Dr. Tarak Patel who trained in Interventional Radiology at Johns Hopkins, VIRA physicians Dr. Arthur McCain (IR fellowship from the University of Florida) and Dr. Todd Jones (IR fellowship from Emory) are also highly skilled in UFE with many years of experience. Call VIRA today at 478.757.8868or schedule your appointment to see if you qualify for effective nonsurgical fibroid care. We want to help you feel better as soon as possible!