Minimally invasive treatment for uterine fibroids

August 19, 2010 By Kevin W. Dickey, M.D., FSIR

Maybe you're one of the estimated 40 percent of women who have fibroid tumors and may suffer from them. These benign muscle tumors, which grow in and out of the uterus, can be aggravating, painful and can cause excessive bleeding during and between periods. Uterine fibroid embolization (UFE) is a minimally invasive procedure and alternative to surgery that shrinks these tumors to reduce symptoms.

Among the symptoms from fibroid tumors, which typically start in a woman's 30s, are:

• heavy and prolonged periods

• pain in the pelvis and with intercourse

• increased urinary and rectal urgency

• and breakthrough bleeding between periods.

Depending on its location, a fibroid tumor may hamper pregnancy.

If you have fibroid tumors that bother you only slightly, they may respond well to conservative treatment like hormone therapy. But, if you have persistent bleeding or pain, UFE might be a treatment option for you. The procedure, conducted by an interventional radiologist, shrinks the aggravating tumors by blocking blood flow to the fibroids. This lessens symptoms and spares the uterus.

UFE is generally an option for premenopausal women under the age of 50 who don't want a future pregnancy. If interested in UFE, discuss it with your gynecologist first. A gynecological exam and Pap smear test without abnormal findings should precede a UFE. At The Hospital of Central Connecticut, interventional radiologists collaborate with gynecologists regarding UFE treatment planning. Other treatment options for fibroids include a hysterectomy, which takes out the uterus, or a myomectomy that removes the fibroids.

During the one- to two-hour UFE, for which you're sedated, a small catheter is placed into the artery at the top of your leg. Under X-ray guidance, the catheter is brought to the arteries that feed the uterus. Tiny, round particles of a type of plastic or gelatin are injected through the catheter. This blocks blood flow to the fibroids, shrinking them to lessen symptoms. The fibroids usually die and become scars. Sometimes fibroids are passed within a few months after the procedure.

UFE procedure risks are small and include infection, early menopause, and rarely, injuries to adjacent organs.

After a UFE, expect to stay in the hospital overnight, receiving pain medication as needed since strong pelvic pain is common within the first 12 hours and can return two to three days later. Recovery is four to seven days and within three months, you should be back to regular, lighter and shorter menstrual cycles.

While you may develop new fibroids after UFE or myomectomy, more and more women are opting for the minimally invasive UFE instead of traditional treatments like hysterectomy.

Dr. Kevin W. Dickey is chief of Interventional Radiology at The Hospital of Central Connecticut, and in 1997 was the first physician in Connecticut to conduct UFE. For more information about uterine fibroid embolization, please call 860.224.5193.