Uterine Fibroid Embolization
WHAT ARE FIBROIDS?
Fibroids are benign growths that develop in the wall of the uterus. While not all fibroids cause symptoms, their size and location can lead to problems for some women, including pain and heavy bleeding. Fibroids can range in size from very small to very large. In some cases, they can cause the uterus to grow to the size of a pregnant uterus or larger.
WHO GETS FIBROIDS?
20-40% of women older than 35— and as many as 50% of African-American women — have uterine fibroids of a significant size. Most women do not experience serious problems and do not seek treatment. In addition to hysterectomy, myomectomy (surgically removing the fibroids), is often recommended to relieve fibroid symptoms. Typically, however, the more fibroids a patient has, the less successful the myomectomy. Additionally, fibroids can grow back years after surgery in 10 to 30% of cases.
WHAT IF I DONT WANT A HYSTERECTOMY?
Women who have painful uterine fibroids have an alternative called fibroid embolization. Interventional radiologists perform the embolization procedure, which involves cutting off blood flow to the uterus, causing the fibroids to shrink.
More than one-third of the 600,000 hysterectomies performed each year are due to fibroids, making them the No. 1 reason for surgical removal of the uterus. However, all patients need to be evaluated by an interventional radiologist to determine if they are candidates for this procedure.
WHAT IS UTERINE FIBROID EMBOLIZATION?
Fibroid embolization is done without surgery. It requires only a tiny nick in the skin about the size of a pen tip. It is performed while the patient is sedated, drowsy, and pain free. Fibroid embolization is performed by an interventional radiologist.
The interventional radiologist makes a small nick in the skin in the groin or wrist, through which a tiny tube called a catheter is inserted into an artery. The catheter is guided through the artery to the uterus while the interventional radiologist watches the progress of the procedure using a X-ray. When the catheter is in place, the interventional radiologist injects small particles the size of grains of sand into the artery that supplies blood to the fibroid tumor. The particles cut off the blood flow to the fibroid and cause it to shrink.
WHAT SHOULD I EXPECT AFTER THE PROCEDURE?
The procedure typically takes about an hour. Patients typically stay one night in the hospital. Recovery time is approximately one week. Vaginal spotting and discharge may occur for several weeks after the procedure. We do not yet know the long-term impact of uterine artery embolization on fertility. There are many case reports in the medical literature of women who have become pregnant after uterine artery embolization.
Society of Interventional Radiology