Uterine Fibroids

If you're a woman in your 30s or 40s experiencing pelvic pain, heavy bleeding, and frequent urination, you may be suffering from a common condition known as uterine fibroids.

These noncancerous growths develop in the wall of the uterus in 20 to 40 percent of women age 35 and older. They vary greatly from tiny nodules to tumors as large as a cantaloupe.

For most women, fibroids either do not cause symptoms or cause only minor symptoms. But when their size and location lead to problems, interventional radiology offers a nonsurgical treatment that is sparing women major surgery.

Until recently, treatment options for uterine fibroids have involved either hormonal medications, hysterectomy-which is removal of the entire uterus or myomectomy taking out the largest fibroid or collection of fibroids. In fact, uterine fibroids are the most common cause of hysterectomy in pre-menopausal women.

With one third of the 600,000 hysterectomies performed annually in the United States due to fibroids, the minimally invasive treatment is a safe solution for a significant public health problem.

Called uterine fibroid embolization (UFE), the procedure blocks the arteries that supply blood to the fibroids, causing them to shrink.

• On average, 90 percent of women experience significant or total relief of heavy bleeding.
• The treatment is about 85 percent effective in relieving pain associated with fibroids.
• Recurrence of treated fibroids is very rare.

The Procedure

For the patient, uterine fibroid embolization is a simple procedure that takes from one to two hours and is performed under local anesthesia with a light sedation. The process involves the following steps:

• The interventional radiologist makes a small nick in the skin in the groin and inserts a tiny catheter tube into the femoral artery.
• Using advanced three-dimensional X-ray, the physician guides the catheter through the artery to the uterus.
• Tiny plastic particles the size of grains of sand are then injected into the artery supplying blood to the fibroids.

When the procedure is done, all the patient has is a little bandage on the skin where the interventional radiologist accessed the artery. Usually, patients stay in the hospital overnight. After discharge, many women resume light activities in a few days, and the majority return to normal activities within seven to 10 days.

Uterine fibroid embolization is becoming the preferred treatments for fibroids. There is less pain, it is easily tolerated, and recovery time is faster. Many physicians see UFE as a first line of treatment today, and recent trials comparing embolization to both surgical procedures bears out the safety and effectiveness of the minimally invasive approach.

Women experiencing fibroid symptoms should talk to their physician to determine whether they are a candidate for uterine fibroid embolization. An ultrasound or MRI will help the intervententional radiologist determine if the treatment option is appropriate for you.