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Uterine Fibroid Embolization: A New Way to Treat Fibroids
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Am Fam Physician. 2000 Jun 15;61(12):3611-3612.
See related article on uterine fibroids.
Your doctor has told you that you have a fibroid in your uterus. There are several ways to treat fibroids. One way to treat women with fibroids is called uterine fibroid embolization. If you and your doctor have decided that this may be appropriate treatment for you, this handout will help explain this procedure.
First, what are fibroids?
Fibroids are benign growths (not cancer) in the muscular wall of the uterus. These growths can be very tiny or as large as a cantaloupe.
Do fibroids cause problems?
Many women with fibroids don't have symptoms. In other women, fibroids can cause heavy bleeding during the menstrual period. Periods may last much longer than usual.
Fibroids may also cause pain or a feeling of pressure or heaviness in the lower pelvic area (the area between the hip bones), the back or the legs. Some women have pain during sexual intercourse. Others have a constant feeling that they need to urinate. There may also be a feeling of pressure in the bowel. Some women have constipation or bloating.
How common are fibroids?
Fibroids are common. Between 20 and 40 percent of women older than 35 years have fibroids. Black women are at a higher risk of having fibroids.
How are fibroids treated?
There are many treatments for women with fibroids. Medicine can shrink some fibroids. Some women need surgery. Two common types of surgery are:
Myomectomy (say: my-oh-mek-toe-me).A myomectomy is surgery that takes the fibroid out of the uterus.
Hysterectomy (say: his-ter-ek-toe-me). A hysterectomy takes the whole uterus out.
A new way to treat women with fibroids is called uterine fibroid embolization.
How does uterine fibroid embolization work?
Fibroids have a large blood supply that makes them grow. Fibroids will shrink or go away completely if the blood supply is stopped. Embolization means to stop or block the blood flow. So, uterine fibroid embolization is a way to stop the blood flow that makes fibroids grow. The procedure works even if you have several fibroids.
How is uterine fibroid embolization done?
Uterine fibroid embolization is not surgery, but it's done at a hospital. You will be given medicine to make you sleepy and relaxed. The procedure doesn't cause pain. The doctor (an interventional radiologist who is specially trained to do this procedure) will make a tiny cut in the skin in your groin area. Next, the doctor will pass a tiny tube called a catheter through an artery to your uterus. When the catheter is in place, the doctor will inject tiny particles into the catheter. These particles, made of plastic or gelatin sponge, are about the size of grains of sand. These particles move through the catheter into the arteries that send blood to the fibroid. The particles will stop the blood flow to the fibroid. Over time, the fibroid will shrink in size.
How successful is uterine fibroid embolization?
About 85 percent of women have a lot of or total relief of pain and other symptoms caused by fibroids.
What are the advantages of uterine fibroid embolization?
There are several advantages. Usually, you only have to stay in the hospital one night after the procedure. You can return to your normal activities about a week after the procedure. This is a much shorter time compared with the six to eight weeks after surgery. There's no significant blood loss. There's no big surgical incision. You don't need general anesthesia.
Are there any side effects from uterine fibroid embolization?
Uterine fibroid embolization is very safe, but there are some side effects. Most women have moderate to severe cramps for the first few hours after the procedure. Some women have nausea and fever. Medicine can help with these symptoms.
A few women get an infection after the procedure. Antibiotics can control the infection. About 1 percent of women have an injury to the uterus from the procedure. This could make a hysterectomy necessary. A few women have started menopause after uterine fibroid embolization. Studies about getting pregnant after having this procedure are not complete.
How do I know if this procedure is right for me?
You, your family doctor, your gynecologist and the interventional radiologist will help you decide if uterine fibroid embolization is right for you. Most insurance companies will pay for this procedure. You will want to talk with your insurance company and your doctors before having this procedure.
Where can I get more information?
For more information on fibroids and their treatment and to find interventional radiologists in your area, you can call the Society of Cardiovascular & Interventional Radiology (SCVIR) at their toll-free telephone number: 1-800-488-7284. You can also access their Web site at: www.scvir.org/.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2000 by the American Academy of Family Physicians.
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