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What are Uterine Fibroids?

Uterine fibroids are very common non cancerous (benign) growths that develop in the muscular wall of the uterus. They can range in size from the very small, several millimeters, to a softball size or even larger. Occasionally, they can cause the uterus to grow to the size of a second or third trimester pregnancy and in most cases there is more than one fibroid in the uterus.

Fibroids can be found in three locations within the uterus: subserosal, intramural and submucosal. Subserosal fibroids develop under the outside covering of the uterus and expand outward through the wall, giving the uterus a bloated appearance on ultrasound and MRI scan. Intramural fibroids are located within the wall of the uterus, and can grow in size over time to cause symptoms relating to their size as well as heavy bleeding. Submucosal fibroids are directly under the lining of the uterine cavity, and even if very small, can be associated with heavy menstrual bleeding.

What are symptoms of Uterine Fibroids?

Although fibroids can be found in 30-50% of women between the ages of 30-50 years old, only a minority of women actually ever have symptoms relating to the fibroids. Symptoms usually fall into two categories: bulk symptoms from an enlarged uterus, and heavy bleeding also known as menorrhagia. Bulk symptoms include pelvic and back pain, frequent urination, abdominal growth and bloating. Menorrhagia usually involves one or more fibroids positioned directly under the uterine lining, and can be associated with severe bleeding during periods and even continuously throughout the month.
If a woman with fibroids has no symptoms or minimal symptoms, then it is generally accepted that no treatment is needed. If symptoms are significant and affecting a woman’s quality of life then she should receive information about all fibroid treatment options that are available.

What are my treatment options for Uterine Fibroids?

The Interventional Radiologists at Mountain Medical Physician Specialists Offer Minimally-Invasive, Uterus-Sparing Treatment for Symptomatic Uterine Fibroids There are many different treatment options for women suffering from symptoms related to uterine fibroids, which may include medication, myomectomy, hysterectomy as well as the often overlooked fibroid embolization. Until recently, hysterectomy was seen as the primary treatment option for uterine fibroids. However in August of 2008 the American College of Gynecology stated there is enough level A evidence to support uterine fibroid emobilization as a viable alternative treatment option to hysterectomy. Uterine Fibroid Embolization (also known as uterine artery embolization), is a minimally invasive treatment option for uterine fibroids, and has been found to be extremely safe and effective in clinical studies.

How does Uterine Fibroid Embolization work?

The procedure begins when a small skin nick is made at the groin and is performed with several tiny catheters and wires to manipulate into the bilateral uterine arteries. Tiny particles are slowly infused into both uterine arteries to enclose the fibroids cutting off blood supply, while maintaining blood flow to the uterus as a whole. Recovery is on an individual basis but typically patients are kept 23 hours for observation and pain control management. All women who undergo fibroid embolization will have cramping and pelvic pain/discomfort for the first 4-6 hours, which is treated with a combination of intravenous anti-inflammatory and narcotics via patient controlled anesthesia (PCA pump).
Patients are then followed closely by telephone and also in- clinic visits during the first several weeks, and all undergo one final MRI pelvis and clinic visit at 6 months. All patients are instructed to return to their primary care physician or gynecologists for ongoing medical care, and to take a week of work off following the procedure. Most women return to full activity within 5-10 days following the embolization.

What are the risks associated with Uterine Fibroid Embolization?

Risks associated from UFE are limited and fortunately rare. Complications, including hematoma, ongoing bleeding or vascular injury are very rare. There is a less than 1% risk of infection following fibroid embolization, which is most often treated successfully with oral and occasionally intravenous antibiotics. Infection of the uterus, requiring further treatment including hysterectomy, is also extremely rare. Vaginal bleeding initially following the procedure is not uncommon and almost always self-limited. Bleeding within the pelvis, as can be seen with myomectomy and hysterectomy, is not considered a risk with fibroid embolization.

How effective is Uterine Fibroid Embolization?

Numerous clinical studies performed throughout the world show 86-95% effectiveness in either significant improvement or complete resolution of symptoms following embolization. The procedure is equally effective for single fibroids, multiple fibroids and even large fibroids. Recurrence of symptoms related to fibroids is rare; with studies showing range of 5-12% return of symptoms, whether that involves growth of new fibroid or re-growth of a previously treated fibroid. Uterine fibroid embolization does not prevent any future treatment of fibroid diseases, whether that includes all surgical options or a second fibroid embolization; a small percentage of patients successfully undergo a second embolization for recurrence of symptoms, with excellent results.

Are you a candidate for UFE?

Most women with symptomatic fibroids are candidates for UFE and can obtain a consultation with an Interventional Radiologist at Mountain Medical to determine whether UFE is a treatment option for them. All women suffering from symptomatic fibroids should have an opportunity to consult with an interventional radiologist to find out more information about fibroid embolization, if they desire a minimally invasive, uterus sparing procedure. The interventional radiologists at Mountain Medical are careful to ensure a woman is actually suffering from fibroid disease, is suffering from significant symptoms and also understands all her treatment options including surgery.
During the consultation, the interventional radiologist will review previous physician notes, laboratory tests, imaging studies, review all fibroid treatment options, and specifically explain and discuss uterine fibroid embolization with the patient. An MRI of the pelvis will be obtained in those patients deciding to pursue uterine fibroid embolization. The MRI is considered the most sensitive imaging tool to confirm the size, location and number of fibroids, and to exclude other pelvic pathology which may affect the appropriateness of any treatment being considered.

For more information or to set up a consultation, call one of our locations today:

Locations

5323 S Woodrow Street
Suite 102
Murray, UT 84107View Map
801-713-1010

1486 E Skyline Drive
South Ogden, UT 84405View Map
801-475-4552