Uterine fibroids are benign tumors of the uterus that often appear in
healthy women during childbearing years. Also called leiomyomas or myomas,
uterine fibroids are noncancerous growths that can cause debilitating
symptoms. Uterine fibroids develop from the smooth muscular tissue of
the uterus (myometrium). A single cell divides repeatedly, eventually
creating a firm, rubbery mass with a rich blood supply that is distinct
from nearby tissue. The growth patterns of uterine fibroids vary —
they may grow slowly or rapidly, or they may remain the same size. Uterine
fibroids are sensitive to a woman’s hormones. They tend to grow
during childbearing years and diminish in size with onset of menopause.
Fibroids may even expand during pregnancy and disappear after pregnancy
as the uterus goes back to normal size. As many as 3 out of 4 women will
have uterine fibroids during their lives. Most women are unaware of them,
because they often have no symptoms. Once symptomatic, fibroids can have
deleterious effects on a woman’s health and lifestyle.
Symptoms may include severe abdominal pain, pelvic pressure, urinary frequency,
constipation, pain with intercourse (dyspareunia), severe anemia from
frequent bleeding requiring blood transfusions, and can affect a woman’s
ability to conceive a child or have a normal pregnancy.
Uterine Fibroid Treatment
Traditional treatment of fibroids has involved surgery such as Myomectomy
and Hysterectomy. Myomectomy is the surgical removal of fibroids
from the wall of the uterus. Hysterectomy is the complete surgical removal
of the uterus. Surgery can involve risks such as adverse reactions to
anesthesia, blood loss, physical trauma, and infection. Recovery time
is longer with surgical therapies.
Uterine Artery Embolization (UAE) is a minimally invasive procedure that
shrinks fibroids by depriving them of blood and nutrients that allow them
to grow. In addition, UAE allows preservation of the uterus. Recovery
from this minimally invasive procedure is shorter, allowing return to
work and usual activities within a few days.
Uterine Artery Embolization
Uterine artery embolization, also known as uterine fibroid embolization
(UFE), involves the placement of a small catheter into the uterine artery and
delivery of small particles to starve the blood supply to the fibroid.
Uterine artery embolization (UAE) is indicated for relief of bothersome,
bulk-related symptoms and abnormal uterine bleeding, also known as menorrhagia.
Fibroid size, number, and location are the potential predictors of symptom
relief and success of UAE.
The procedure is performed under sedation with local anesthesia. Access
is commonly through the radial or femoral artery via the wrist or groin,
respectively. The artery is accessed by a needle puncture. An access catheter
is then introduced into the artery. In order to select the uterine vessels
for subsequent embolization, a guiding catheter is placed into the uterine
artery under x-ray fluoroscopy guidance. Once at the level of the uterine
artery, an angiogram with contrast is performed to confirm placement of
the catheter and tiny particles are injected. The particles will follow
the direction of blood flow to the fibroids until blood flow to the fibroid
slows significantly or ceases altogether. This interruption of blood supply
to the fibroids will cause them to shrink over time. The blood supply
to the remaining healthy part of the uterus is not affected. UAE has satisfaction
rates similar to hysterectomy in relation to symptom relief and offers
much shorter recovery times. UAE can also be used to control heavy uterine
bleeding for reasons other than fibroids, such as postpartum obstetrical
hemorrhage and adenomyosis.
For more information about the Uterine Artery Embolization procedure at
Good Samaritan Hospital call (213) 977-2239.