Interventional Radiology Offers a Non-Surgical Treatment for Uterine Fibroids
Uterine fibroids are a common condition and by the age of fifty, can affect about 20-80% of women [1]. Fibroids can cause significant symptoms including vaginal bleeding, pelvic pain, pelvic pressure, and urinary symptoms.
In the past, treatment for uterine fibroids included myomectomy or hysterectomy, which consisted of surgically excising fibroids under general anesthesia. However, newer technologies and techniques have allowed for minimally invasive methods to successfully treat uterine fibroids, often under moderate sedation.
One of the newest treatments for fibroids is made possible through interventional radiology.
Interventional radiology (IR) is a minimally invasive specialty that uses wires and catheters under direct image-guidance to treat different pathologies throughout the body, using only a small skin incision to enter blood vessels. For more than three decades, IR has been treating uterine fibroids successfully with many advancements in the field. This procedure is called “uterine fibroid embolization (UFE)” or “uterine artery embolization (UAE).”
There has been significant research conducted on long-term outcomes regarding UFEs, which have all demonstrated substantial long-term symptom improvement [2]. Based on strong evidence, the American College of Obstetrics and Gynecologists Practice Bulletin endorses UFEs as a safe and effective method of treating uterine fibroids, especially for women who wish to keep their uteri.
If you are suffering from uterine fibroids, call us to book an appointment to discover what fibroid treatment options are available to you.
What are Uterine Fibroids?
Uterine fibroids, also referred to as leiomyomas, are benign masses caused by unregulated proliferation of smooth muscle cells in the myometrium. It is the most common tumor found in females. You may have a singular fibroma, or multiple.
Types of Fibroids
There are different types of uterine fibroids including:
- Subserosal: These are the most common types of fibroid, which grow on the outer uterine wall. When they are connected to the uterus by a thin stalk, they are termed “pedunculated”
- Intramural: These develop in the muscular wall of the uterus, also known as the “myometrium”
- Submucosal: These are the most uncommon and grow on the inner lining of the uterus
What are the Symptoms of Uterine Fibroids?
Symptoms of uterine fibroids vary from patient to patient. Some patients do not experience any symptoms. For those that do, some symptoms uterine fibroids include:
- Heavy menstrual bleeding: When fibroids are deep in the uterine cavity and distort the endometrial lining, patients may experience heavy menstrual bleeding
- Pelvic pain and/or menorrhagia: Pain symptoms may vary. Some may experience menstrual pain and cramping to different degrees. Some may also experience tenderness or constant, dull pain at the site of the fibroid
- Pelvic pressure: Many patients with fibroids experience “bulk symptoms” which include feelings of fullness, heaviness, or bloating
- Genitourinary symptoms: Patients may experience urinary symptoms (frequency, urgency, incontinence, or retention). In some cases, if the fibroid affects the renal draining system, hydronephrosis and accompanying renal symptoms may occur. Patients may also experience dyspareunia, or discomfort during sexual intercourse
- Infertility and/or complications during pregnancy: Patients with significant fibroids may have trouble achieving pregnancy as the fibroid may distort the uterus and its endometrial lining, creating an unideal environment for embryo implantation
What Causes Uterine Fibroids?
Current research suggests that fibroids are a result of proliferation of the muscle cells in the uterus. It is thought that estrogen hormone plays a role in promoting the growth of fibroids.
Risk Factors for Developing Fibroids
The development of fibroids is most associated with age. Fibroids are most likely to occur in a woman’s reproductive years.
Patients at greater risk of developing fibroids include:
- Those with family history
- Those who are obese
- Those with high blood pressure
- Black women
How are Fibroids Diagnosed?
Fibroids are diagnosed based on patient history, symptoms, and diagnostic imaging. Diagnostic imaging will be thoroughly reviewed which may include magnetic resonance imaging (MRI), computed tomography (CT), or pelvic ultrasound (US).
In some cases, your gynecologist may suggest a hysterosalpingography (a type of x-ray using special dyes to assess if fibroids are blocking the fallopian tubes) or a hysteroscopy (direct visualization into the uterus using a camera inserted through the vaginal canal).
What is the Best Treatment for Fibroids?
There are various treatments for fibroids and the best option for you depends on symptoms, size and location, age, medical history, reproductive goals, and preferences. Medicine or surgery may be options.
For those that wish to preserve fertility, the most favorable option for treating fibroids is uterine fibroid embolization. Uterine artery embolization (UAE) is a minimally invasive option done by an IR doctor specializing in fibroid removal using image-guided procedures. There is significant long-term evidence supporting the use of UAE.
If you or a loved one are living with fibroids, there are options. Please contact us to learn more.
References:
[1] Marsh EE, Al-Hendy A, Kappus D, Galitsky A, Stewart EA, Kerolous M. Burden, Prevalence, and Treatment of Uterine Fibroids: A Survey of U.S. Women. J Womens Health (Larchmt). 2018;27(11):1359-1367. doi:10.1089/jwh.2018.7076
[2] Spies JB. Current evidence on uterine embolization for fibroids. Semin Intervent Radiol. 2013;30(4):340-346. doi:10.1055/s-0033-1359727