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Alternative uterine fibroids treatment |
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Uterine fibroids are non-cancerous (benign) growths that develop in the muscular wall of the uterus. They are very common in women during their childbearing years and are often very small and cause no problems. However, between 20 and 40 percent of women aged 35 and older have uterine fibroids of significant size. And African-American women are at higher risk as many as 50 percent have fibroids of significant size. Women with uterine fibroids can experience a range of symptoms depending on the number, size and location of them. Fibroids can range in size from very small to a very large mass that can make some women appear to be in their fifth month or more of pregnancy. Symptoms can include prolonged menstrual periods and unusual monthly bleeding (sometimes associated with clots). This excessive bleeding can lead to anemia (a condition in which the blood is deficient in red blood cells, hemoglobin or total volume). Other symptoms include pelvic pain and pressure with heaviness, pain during sexual intercourse, bladder and bowel pressure and, if the fibroids are large, they can cause an abnormally large abdomen. The symptoms typically improve after menopause; however, menopausal women who are taking supplemental estrogen (hormone replacement therapy) may not experience symptom relief. Appropriate treatment of fibroids depends on their size and location, as well as the severity of the symptoms. Most fibroids do not cause symptoms and therefore are not treated. When they do cause symptoms, drug therapy is often the first step in treatment. In many patients, symptoms are controlled with medication and no other therapy is required. However, if the therapy is discontinued, fibroids often grow back. If the fibroids do not respond to drug therapy, the next step typically has been surgery either myectomy, the surgical removal of the fibroids or a complete hysterectomy, removal of the uterus and often the cervix and ovaries. However, there is now an alternative approach called uterine fibroid embolization or UFE. UFE is a minimally invasive procedure that stops the blood supply to the fibroid. An experienced interventional radiologist places a very small catheter through a tiny puncture in the patient's groin. The catheter injects tiny pellets called microspheres into the two arteries that supply blood to the fibroid. This closes the arteries off and blocks the blood flow to the uterus and fibroid. The fibroid then shrinks and sometimes breaks down. The procedure is performed while the patient is conscious but sedated drowsy and feeling no pain and usually takes less than one hour. This procedure usually requires a one-night stay in the hospital with medication to control the cramping and pain. Some patients can experience fever or nausea, which can be treated. Typically, patients are able to return to normal activity within one week. Other benefits of UFE are:
Overall, UFE is a safe procedure for treating symptomatic fibroids with minimal risk. However, as with almost any medical procedure, there are some associated risks, including common short-term allergic reaction/rash, vaginal discharge/infection and possible fibroid passage. Most symptoms can be controlled with appropriate medication. The UFE complication rate is much lower than those of hysterectomy and myomectomy. The success rate of UFE is also very encouraging. Most studies show 78 percent to 94 percent of women who have the procedure experience significant or total control of their heavy bleeding, pain and other symptoms. Recurrence of treated fibroids is rare. Studies on the long-term affects of uterine fibroid embolization on the ability of the women to have children have not been fully determined. Pierre A. Zayat, M.D., F.A.C.R. (Fellow of American College of Radiology) is section chief of vascular and interventional radiology at St. John Hospital and Medical Center and has performed a large number of UFE procedures with excellent results. |
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