Uterine Fibroids and Uterine Artery Embolization
Advanced Treatment Makes a Major Difference
There are several treatment options available to women who have severe symptoms associated with uterine fibroids. Medications may help shrink fibroids, and surgery can be performed to remove the fibroids (myomectomy) or the uterus (hysterectomy). But the medications aren't always effective, and many women are reluctant to undergo major invasive surgery.
Now, many women are choosing a new procedure called uterine artery embolization (UAE). During this procedure, an interventional radiologist makes a tiny cut in the groin area, inserts a thin catheter into the groin and uses imaging technology to guide the catheter to the uterus. Next, the physician injects tiny particles into the arteries on both sides of the uterus. These particles block blood flow to the uterine fibroids. Without a supply of blood, the fibroids shrink over time.
"UAE is a major advance that dramatically improves the quality of women's lives," says Anthony Venbrux, MD, Director of Interventional Radiology at The George Washington University Hospital. "Instead of the large incision and lengthy recovery associated with conventional surgery, women treated with UAE stay overnight in the hospital and can usually resume their normal activities within a week. And most patients find that UAE reduces or completely relieves their symptoms."
How Effective is the Procedure?
Research has shown fibroid embolization to be at least 85 percent effective in reducing bleeding and alleviating pain. Many women have described significant change in their symptoms within days. Furthermore, since the procedure avoids surgery, many women can go back to routine daily activities by the next day.
Although definitive studies have not been completed on the effect of fibroid embolization on a woman's fertility, early evidence suggests that fibroid embolization generally does not disrupt reproductive function and may be an option for women who wish future pregnancy.
What Can I Expect After the Procedure?
Fibroid embolization usually requires a hospital stay of one night. Total recovery generally takes one to two weeks, but can take longer. Fibroid embolization is considered to be very safe, however, there are some associated risks, as there are with almost any medical procedure. A small number of patients age 45 or older reportedly have entered into menopause after embolization. A number of insurance companies are paying for fibroid embolization procedures.
Recovery time for patients undergoing transcatheter embolotherapy for fibroids is approximately one week. Vaginal spotting and discharge may occur for several weeks after completion of the procedure. We do not yet know the potential long-term impact of uterine artery embolization on fertility. Case reports have appeared in the medical literature of women who have become pregnant after uterine artery embolization for fibroids.