A Non-Surgical Treatment Option for Managing Fibroids

Uterine fibroids are very common non-cancerous growths that develop in the muscular wall of the uterus. While fibroids do not always cause symptoms, their size and location can lead to problems for some women, including pelvic pain, heavy bleeding and in some cases infertility.

The cause of fibroids is unknown but research suggests that some women may have a genetic predisposition to fibroid development and that estrogen plays an important role in the formation of fibroids. Typically, fibroids worsen as a woman enters her 30s and 40s and then the fibroids shrink when estrogen levels drop at menopause.

The traditional treatments for fibroids have largely been major abdominal surgeries such as hysterectomy or myomectomy, requiring long and uncomfortable recovery times. Now, a new procedure, uterine fibroid embolization, gives women a safe alternative to hysterectomy. This approach to the treatment of fibroids blocks the arteries that supply blood to the fibroids causing them to shrink. It is a minimally-invasive, non-surgical procedure, which means it requires only a tiny nick in the skin, and is performed while the patient is conscious but sedated - drowsy and feeling no pain.

Uterine Fibroid Embolization is now available at Paoli Hospital and performed by an interventional radiologist who is specifically trained to perform this and other minimally invasive procedures.

How are Uterine Fibroids Diagnosed?
Typically, fibroids are first diagnosed during a gynecologic internal examination. Your doctor will conduct a pelvic exam to feel if your uterus is enlarged. The presence of fibroids is most often confirmed by an abdominal ultrasound. Fibroids also can be confirmed using magnetic resonance (MR) and computed tomography (CT) imaging techniques.

The Uterine Fibroid Embolization Procedure
Fibroid embolization is performed by an interventional radiologist, a physician who is specially trained to perform this and other minimally-invasive procedures.

The interventional radiologist makes a small nick in the skin (less than one-quarter of an inch) in the groin, and inserts a tiny tube into the femoral artery. The catheter is guided through the artery to the uterus using advanced 3-D x-ray imaging (fluoroscopy). The interventional radiologist injects tiny plastic particles the size of grains of sand into the artery that is supplying blood to the fibroid tumor. This cuts off the blood flow and causes the tumor (or tumors) to shrink. The artery puncture where the catheter was inserted is cleaned and covered with a bandage.

Expected Results
Fibroid embolization usually requires a hospital stay of one night. Medications that control swelling typically are prescribed following the procedure to treat cramping and discomfort. Many women resume light activities in a few days and the majority of women are able to return to normal activities within seven to 10 days.

• On average, 90 percent of women who had the procedure experience significant or total relief of heavy bleeding.
• The procedure is about 85 percent effective in treating the pain caused by fibroids.
• Recurrence of treated fibroids is very rare.

Menstruation and Fertility
This procedure does not stop normal menstruation in most women. It does stop the abnormal bleeding caused by the fibroids. While this procedure does not result in infertility, it is not recommended that this procedure be performed in women desiring future pregnancy. After having this procedure, you should continue to use your usual method of contraception.

FDA Approval
All devices, equipment and medications used for fibroid embolization are approved by the FDA.

Side Effects/Complications
You should talk to your doctor about possible risks of any procedure you may choose.

Insurance
Most insurance companies pay for fibroid embolization. You will want to talk with your interventional radiologist about this before you procedure.

For more information or to schedule an appointment with a 
Bryn Mawr Hospital interventional radiologist, Call 1-866-CALL-MLH.