Uterine Fibroid Embolization: A Safe and Effective Alternative to Surgery

If you€™ve been diagnosed with uterine fibroids in Chicago, you€™re not alone. The National Institutes of Health concluded that the majority of American women will develop uterine fibroids at some point in their lives1. With symptoms such as urinary incontinence, painful intercourse, and heavy periods that can lead to iron-deficiency anemia, fibroids take a toll both physically and mentally.

A hysterectomy, or the surgical removal of the uterus, was at one time the go-to treatment for fibroids. But now women have other less-invasive options to choose from€”options like uterine fibroid embolization (UFE), which can offer dramatic relief while still sparing the uterus.

€œUterine fibroid embolization is for those women who would like to avoid surgery,€ says Dr. Paramjit €œRomi €œ Chopra, Medical Director at the Midwest Institute for Minimally Invasive Therapies, PC (MIMIT) in Chicago.

With its launch dating back to 1995, UFE may be considered a relatively novel procedure. But previous to this, the basic technique of uterine artery embolization had been safely and successfully used to stop heavy bleeding after childbirth2.

woman's imageDuring UFE, a catheter (a linguini-like tube) is routed through a small incision in the upper thigh. routed through a small incision in the left wrist or upper thigh. Using special imaging equipment, the catheter is guided through the radial artery in the wrist or the femoral artery in the leg and into the uterine arteries. Small particles are then injected in the uterine arteries to block the blood flow that feeds the fibroids, causing them to shrink and die3.

And the success rate for UFE is noteworthy. €œIn my experience over 90 percent of women will see a substantial improvement in symptoms within the first three months when they come back for their follow up visit. Depending on the symptoms pre-procedure, their menstrual bleeding has improved considerably as the fibroids shrink and they get relief from pain, discomfort and bloating along with decreased urinary frequency.€ Dr. Chopra explains. €œMost of them share their relief along with sheer disbelief that they allowed themselves to suffer for such a long period as they didn€™t want a hysterectomy. UFE is an excellent procedure for women and they should be informed of the option as they seek treatment.€

Although UFE was once thought to only be effective with small to medium fibroids, recent research has shown that it can provide relief for large fibroids as well. Earlier this year, a study published in Cardiovascular and Interventional Radiology observed the results UFE had on two groups of women, those with small fibroids of less than 10 centimeters in diameter and those with large fibroids of greater than 10 centimeters in diameter. After the surgery, follow up reports showed both groups having similar improvement in quality of life scores. The authors of the study also found there weren€™t significant differences in treatment effectiveness or post-op complications between the two groups4.

UFE success rates are high but there are times when it doesn€™t work. In some instances UFE is unable to destroy the fibroids completely €œdue to anatomy or other issues,€ Dr. Chopra explains. €œIf the fibroids are completely destroyed, they won€™t come back. However, if a small percentage of fibroids remain post-embolization, they could grow back.€ There are also fibroids too difficult to target. €œFibroids that are too small or ones on the outside of the uterus are a little more difficult to treat. In such cases we might not be able to destroy the fibroids at all.€ At times like these, subsequent treatments or other procedures may be warranted5.

As with any procedure, complications associated with UFE are possible but these are less in comparison to surgical procedures like myomectomy and hysterectomy. €œThere are known complications with surgery including damage to the uterus or abdomen, which is highly unlikely with UFE,€ says Dr. Chopra. €œUFE is a safe and effective choice for women with symptomatic uterine fibroids who want to avoid surgery, preserve their uterus and want a short recovery.€


REFERENCES

1.      National Institutes of Health. (2013). Uterine Fibroids. Retrieved April 28, 2015, from http://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=50

2.      Society of Interventional Radiology. (2015). Highly Effective, Widely Available, Interventional Radiology Treatment Often Replaces Need For Hysterectomy. Retrieved April 28, 2015, from http://www.sirweb.org/patients/uterine-fibroids/

3.      King, R., & Overton, C. (2011). Management of fibroids should be tailored to the patient. The Practitioner, 255(1738): 19-23, 2-3.

4.      Bérczi, V., Valcseva, E., Kozics, D., Kalina, I., Kaposi, P., Sziller, P.,  Várbíró, S., Botos, E. M. (2015). Safety and effectiveness of UFE in fibroids larger than 10 cm. CardioVascular and Interventional Radiology. doi:10.1007/s00270-014-1045-4

5.      Gupta, J. K., Sinha, A., Lumsden, M. A., & Hickey, M. (2014). Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD005073.pub4.