What are uterine fibroids?
A uterine fibroid (leiomyoma) is a specific type of tumor that occurs in the muscle cells of the uterus. Uterine fibroids are benign growths in the uterus that can alter a woman’s period in many different ways. Research has shown that that uterine fibroids will affect 70 percent of white women and 80 percent of African American women in the U.S. by the time they are 50 years old. These growths do not spread to other regions of the body, as with other tumors, and are typically not dangerous. You are at increased risk for developing fibroids if you are overweight, African American, over the age of 40, have high blood pressure, have had no children, and have a family history of fibroids.
What are the symptoms of uterine fibroids?
- Uterine pressure or pain
- Heavy menstrual bleeding
- Severe cramps
- Abdominal enlargement
- A bloated feeling
- Pain during or following intercourse
- Pain down the back of one or both legs
- Constipation
- An urge to urinate frequently
Because most women will not exhibit every potential symptom, diagnosis is usually confirmed by using imaging of the pelvis, with transvaginal ultrasound or MRI.
How do IRs treat uterine fibroids?
Fibroids require a blood supply (for oxygen and nutrients) to continue to grow. Without it, some or all of the tumor will die. To treat the uterine fibroids, an interventional radiologist (IR) can perform a treatment called uterine fibroid embolization, or UFE. UFE avoids surgery, preserves your uterus controls symptoms and improves quality of life. Approximately nine out of 10 women who undergo uterine fibroid embolization will experience significant improvement, or their symptoms will go away completely.
Under X-ray guidance and sedation, the interventional radiologist can access the blood vessel carrying nutrients to the tumor through a small incision in the wrist or groin. The IR then guides a very thin catheter (about the size of a strand of spaghetti) into the incision and through your blood vessels to the specific artery supplying blood to the fibroid.
Once the catheter is in the proper position, the doctor releases small particles at the targeted location to block the small vessels and deprive the fibroid of nutrients shrinking the fibroid. If necessary, the IR can position the catheter in other arteries feeding the uterine fibroid and repeat the process. When embolization is completed, the catheter is removed, and pressure is applied to the small incision to allow it to heal.
After undergoing uterine fibroid embolization, you may be admitted overnight in the hospital to manage any pain resulting from the treatment. Typically, you’ll be sent home with oral pain medication to use for an additional few days. Most women are back to their normal activity in about one week. You’ll follow up with the interventional radiologist and your gynecologist a few weeks later.
What are the risks of uterine fibroid embolization?
The risks associated with UFE include bleeding, infection at the incision site, or adverse reactions to the imaging agents used during the treatment. There is a small risk of inducing menopause, especially in women over 45 years of age.
Seventy-two hours after undergoing UFE, some women may experience symptoms of post-embolization syndrome, including pelvic pain and cramping, nausea/vomiting, low-grade fever, fatigue, and discomfort. These symptoms may resolve themselves and disappear within 2-7 days.
Because the fibroid tissue dies during the UFE, there is a small risk of infection until scar tissue forms. You’ll be carefully observed for signs of infection.