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What are uterine fibroid?
Uterine fibroids are very common non-cancerous (benign) growths that develop in the muscular wall of the uterus. They are most common among women of childbearing age and more prevalent among African-American women. Fibroids are the cause of more than 200,000 hysterectomies every year. Fibroids are classified according to their location in the uterus.
Some fibroids produce mild or no symptoms, while others can cause considerable pain/pressure and limit your lifestyle. The most common symptoms are:
- Heavy or frequent menstrual periods
- Pelvic pain/pressure
- Pain during or after sexual intercourse
- Urinary frequency
- Constipation and/or bloating
- Abnormally enlarged abdomen
Diagnosing Uterine Fibroids:
Some women live with fibroids and do not have any symptoms. Routine gynecologic exams, detailed description of symptoms, and certain imaging studies can accurately diagnose fibroids. These imaging studies can include ultrasound, magnetic resonance (MRI) or computed tomography (CT) of the pelvis.
Treatment Options For Uterine Fibroids:
Based on your medical history, severity of symptoms, and location and size of your fibroids, your options for treatment may include:
- Medications (these only treat symptoms and do not have a direct effect on the fibroids)
- Surgery (myomectomy or hysterectomy)
- Non-surgical treatment (Uterine Fibroid Embolization)
What is Uterine Fibroid Embolization?
Uterine fibroid embolization (UFE), also known as uterine artery embolization, is performed by an interventional radiologist, a physician who is trained to perform this and other types of embolization and minimally invasive procedures. It is performed while the patient is conscious, but sedated and feeling no pain. It does not require general anesthesia.
The interventional radiologist makes a tiny nick in the skin in the groin and inserts a microcatheter into the femoral artery. Using real-time imaging, the physician guides the microcatheter through the artery and then releases small spheres, the size of grains of sand, into the uterine arteries that supply blood to the fibroid tumor. This blocks the blood flow to the fibroid tumor and causes it to shrink and reabsorb over time.
The Advantages of UFE
- Preserves the uterus
- Minimally invasive
- Low complication rate
- Short recovery time
- Treats all the fibroids with one procedure
- Recurrence is rare
- No adhesions or scar tissue
- General anesthesia not necessary
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Who is a Good Candidate for UFE?
The UFE procedure may be a good treatment option for women experiencing the symptoms of uterine fibroids but who are not ideal surgical candidates. Uterine fibroid embolization is a non-surgical alternative to hysterectomy or myomectomy so may also be considered by women who prefer to retain their uterus. While the UFE procedure can achieve this, it may affect a woman's ability to become pregnant in the future. Therefore, the best candidates for this procedure are not tied to the idea of expanding their families. Patients should be in good general health and cannot have an active or recent pelvic infection. UFE may not be suitable for women who have a bleeding disorder, impaired renal function, or a form of reproductive cancer. If you are experiencing the symptoms of uterine fibroids, talk to your gynecologist. A thorough medical history review, consultation, and examination can help you and your doctor determine the best course of treatment for your situation.
How Long Does the UFE Procedure Take?
A viable alternative to surgery, the UFE procedure does not require anesthesia, and patients generally enjoy a shorter recovery period after their procedure. Additionally, the treatment itself usually takes only an hour to 90 minutes.
What are Key Advantages to UFE?
Uterine fibroid embolization preserves the uterus, decreases heavy menstrual bleeding from symptomatic fibroids, decreases urinary dysfunction, decreases pelvic pain and/or pressure, has virtually no blood loss, and is typically performed as an outpatient procedure. It offers shorter hospital stay and a faster return to work when compared to having a hysterectomy. It is a safe procedure that involves minimal risk and fewer complications after 30 days when compared to having hysterectomy.
How Can I Prepare for Uterine Fibroid Embolization?
There is very little to do to prepare for the UFE procedure due to the fact that it is a non-surgical treatment. Patients may continue taking most or all of their routine medications, with the exception of blood thinners. Medications and supplements that thin the blood must be avoided for several days before uterine fibroid embolization. It is necessary to consume only water during the six hours before the procedure. No food or beverages should be consumed two hours prior to treatment.
Are Results Permanent?
According to studies, approximately 90 percent of women treated with the UFE procedure experience complete or significant resolution of their fibroid symptoms, including urinary frequency, pressure, pain, and heavy bleeding. The UFE procedure may not completely remove the fibroids, but it shrinks them to half of their original volume and it also causes them to soften so they do not press upon adjacent organs. Studies indicate that uterine fibroids rarely regrow after the embolization procedure. It is also uncommon for new uterine fibroids to grow after treatment. Experts believe that this is because the UFE procedure may treat known fibroids as well as small fibroids that were not picked up on imaging scans.
What are the Risks Associated with UFE?
Although conservative, uterine fibroid embolization is not without risk. During our consultation for treatment, patients are made aware of risks such as the following:
- Bruising, bleeding, or damage to the blood vessel that holds the catheter used during treatment.
- Infection is a risk that is present anytime the skin is punctured or broken.
- The embolic agent can lodge in the wrong location and deprive tissue of oxygenation.
- Allergic reaction to the contrast material used during the procedure. Constant monitoring enables us to immediately treat any signs of allergic reaction.
- Persistent symptoms after the embolization treatment.
Is UFE Covered by Insurance?
Most insurance companies, including Medicaid, cover at least some of the costs associated with treating symptomatic fibroids. Patients should contact their insurance provider directly for detailed information regarding their coverage.
What should you expect after a UFE procedure?
- You will be prescribed medications for pain management
- You may not drive while taking the prescription pain medication
- Symptoms will markedly improve in 90% of patients
- Treated fibroids rarely recur
- You will need to take off work 1-2 weeks (compared to 4-6 weeks for surgical procedures.)