Minimally Invasive, Highly Effective and
Widely Available Interventional Radiology Treatment Is Underutilized
Uterine fibroids are very common non-cancerous (benign) growths that develop in the muscular wall of the uterus. They can range in size from very tiny (a quarter of an inch) to larger than a cantaloupe. Occasionally, they can cause the uterus to grow to the size of a five-month pregnancy. In most cases, there is more than one fibroid in the uterus.
Twenty to forty percent of women ages 35 and older have uterine fibroids of a significant size. African American women are at a higher risk for fibroids: as many as 50 percent have fibroids of a significant size. Uterine fibroids are the most frequent indication for hysterectomy in pre-menopausal women and, therefore, are a major public health issue. Of the 600,000 hysterectomies performed annually in the United States, one-third of these are due to fibroids.
Most fibroids do not cause symptomsonly 10 to 20 percent of women who have fibroids require treatment. Depending on size, location and number of fibroids, symptoms may include:
About the Procedure
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, less than one-fourth of an inch, in the groin and inserts a catheter into the femoral artery. Using real-time imaging, the physician guides the catheter through the artery and then releases tiny particles, 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.
Fibroid embolization usually requires a hospital stay of one night. Pain-killing medications and drugs that control swelling are typically prescribed following the procedure to treat cramping and pain. Many women resume light activities within a few days and the majority of women are able to return to normal activities within seven to ten days.
Other UFE Facts
Effect on Fertility
There have been numerous reports of pregnancies following uterine fibroid embolization, however prospective studies are needed to determine the effects of UFE on the ability of a woman to have children. One study comparing the fertility of women who had UFE with those who had myomectomy showed similar numbers of successful pregnancies. However, this study has not yet been confirmed by other investigators.
Less than 2 percent of patients have entered menopause as a result of UFE. This is more likely to occur if the woman is in her mid-forties or older and is already nearing menopause.
UFE is a very safe method and, like other minimally invasive procedures, has significant advantages over conventional open surgery. However, there are some associated risks, as there are with any medical procedure. A small number of patients have experienced infection, which usually can be controlled by antibiotics. There is also a less than one percent chance of injury to the uterus, potentially leading to a hysterectomy. These complication rates are lower then those of hysterectomy and myomectomy.
Other Treatments for Fibroids
Gynecologists perform hysterectomy and myomectomy surgery. Hysterectomy is the removal of the uterus and is considered major abdominal surgery. It requires three to four days of hospitalization and the average recovery period is six weeks.
Depending on the size and placement of the fibroids, myomectomy can be an outpatient surgery or require two to three days in the hospital. However, myomectomy is usually major surgery that involves cutting out the biggest fibroid or collection of fibroids and then stitching the uterus back together. Most women have multiple fibroids and it is not physically possible to remove all of them because it would remove too much of the uterus. While myomectomy is frequently successful in controlling symptoms, the more fibroids the patient has, generally, the less successful the surgery. In addition, fibroids may grow back several years later.
Myomectomy, like UFE, leaves the uterus in place and may, therefore, preserve the womans ability to have children.
What to Expect Before, During & After the Procedure
Who will perform my procedure?
Your procedure will be performed by one of the interventional radiologists at Reston Hospital Center. All three are sub-specialty trained in interventional radiology. This team has performed thousands of interventional procedures and hundreds of embolizations. Our clinical service also includes three technologists and four nurses. The interventional radiologists at Reston Hospital Center are part of Reston Radiology Consultants, P.C. (RRA).
Where is my procedure performed?
All procedures are performed at Reston Hospital Center. In addition to the medical staff, experienced and highly qualified technologists and nurses are involved in your care during your procedure and afterwards.
Does insurance cover UFE?
Most insurance companies in this area will cover the cost of UFE, as it is not an experimental procedure. Over four thousand have been performed in the United States. We can assist you in determining whether your insurance company will cover the cost of this procedure.