Women with symptomatic uterine fibroids know how disruptive and limiting they can be: painful, heavy periods; abdominal bloating; abdominal and pelvic pain and pressure; even fatigue and anemia from bleeding too much during their periods. Some women with fibroids just want to have their uterus out and opt for hysterectomy. Other women are not comfortable with the idea of losing their uterus, or do not want to undergo a major surgery that requires a lot of time away from work or their normal lives. Myomectomy, or surgical removal of the fibroid or fibroids, is another option, but this may involve major surgery, depending on the technique.
Uterine fibroid embolization is a great option for women with painful fibroids who want to preserve their uterus and have relief from their symptoms with a minimally invasive procedure.
How fibroid embolization works
Embolization means cutting off blood supply using material that is placed inside the blood vessel. In uterine fibroid embolization, a small catheter or tube is placed in the arteries that supply the uterus. Tiny particles are placed into the arteries, and these particles block the blood supply to the fibroids. Some of the normal uterine tissue gets embolized, too, but most of the particles go to the very vascular fibroid. Starved of blood, the fibroids die and shrink over time.
How effective is fibroid embolization?
Studies looking into the long term results of fibroid embolization reveal that the procedure is very effective. About 85% of patients report that their symptoms of bleeding and pain improved after embolization. Since it takes time for the fibroids to shrink, symptoms related to fibroid bulk - like abdominal bloating - will take longer to resolve. A study asking women about their experiences 5 years after embolization indicated that more than 75% of people would do embolization again.
What to expect before, during and after the procedure
Initially, someone interested in embolization will meet with one of our interventional radiologists, either Dr. Wiant, Dr. Patton, or Dr. Hunnicutt (our fellowship-trained IR doctors). During that consultation, we will talk about your symptoms, medical and surgical history, and your goals for treatment. We will also talk about your questions and concerns.
If you are interested in embolization, you will get an MRI of the pelvis. This is for two purposes: to look at where exactly the fibroids are (some types of fibroids are not well treated with embolization), and to look at the fibroid blood supply. The MRI also serves as a baseline study to see how well you do with treatment.
The procedure is done at Trinity’s Heart Center, where our angiographic x-ray equipment is located. You will get an IV and some bloodwork done in our holding area. When you get into the angiographic suite, a bladder catheter will be placed and we will give you medication to relax and fall asleep. After the procedure, you will go to our Women’s Health unit in the hospital. You will have a PCA pump, in which you control the amount of pain medication you receive. You will also get anti-inflammatory and anti-nausea medications. An overnight stay is usual after embolization. The reason for this is so that we can keep your pain and nausea controlled. Some people have a lot of pain and cramping after the procedure, during the acute phase of the fibroid losing its blood supply.
After the procedure
Most women are back at work or to their usual activities 7-10 days after the procedure. You will receive detailed instructions for self care and what to expect after the procedure. Some women have spotting, low-grade fever, malaise, or nausea in the days after recovery. These issues are expected.
So what’s the downside?
Any medical procedure has risks associated with it. Risks associated with the procedure include damage to the arteries in your abdomen and legs; allergy or kidney damage due to the contrast dye used; low blood pressure or oxygenation from sedation. From the embolization itself, embolization of the ovaries, bladder, or skin is possible but extremely rare. Infection of the uterine lining or the uterus is rare but possible. Hysterectomy could be required for treatment. Depending on the location of the fibroid, it may slough off and pass through the cervix and may require a surgical procedure to remove. Women undergoing embolization also are at temporary increased risk of getting blood clots in the lungs. All this being said, fibroid embolization is generally very safe and well tolerated by patients.
Uterine artery embolization is a safe, effective, minimally invasive option for treatment of painful fibroids. Steuben Radiology Associates is excited to bring this service to women in the Ohio Valley.
Ready to schedule a consultation? Call Trinity at 740-264-8287.