Uterine leiomyomas, also known as fibroids, are common benign growths that are part of the normal aging process of the uterus. It has an increasing prevalence with age and are often asymptomatic, causing no significant discomfort. In a minority of patients, depending on the size and location of these growths, patients may experience excessive hemorrhage, pelvic pain, irregular menstrual cycles and bulk-related symptoms; the latter are symptoms directly related to the pressure to adjacent organs from large fibroid uterus that can manifest as constipation, bloating, urinary frequency, incontinence, obstruction, etc.
Fibroid related symptoms are often managed conservatively by various available oral medications. Patients who fail conservative management with high-level symptoms have traditionally been offered endometrial ablations, myomectomies, and hysterectomies. Uterine artery/fibroid embolization (UAE/UFE) provides a safer and as effective alternative with preservation of future fertility.
UAE is done by interventional radiologists through a small needle puncture at the wrist or groin without any large incisions. This significantly improves the adverse effects and speeds up the recovery process. A long, thin catheter is then navigated carefully to the uterus and occlusive agents are used to stop the blood flow to the fibroids (figure 1). This over time causes the fibroids to shrink, while preserving the normal uterus, with significant symptom improvement seen in most patients within a few cycles. This procedure has also been shown to improve symptoms in patients with refractory symptomatic adenomyosis without the need for a hysterectomy (figure 2).
UAE is FDA approved and has been performed worldwide for over 20 years. It can prevent the need for a hysterectomy in about two thirds of patients with symptomatic fibroids with comparable improvement in quality of life documented up to 10 years after the procedure. Studies have also shown successful pregnancies in women following UAE, making this a viable option for those wishing to preserve fertility. For more information on UAE, please call to schedule an appointment with one of our experienced interventionalists at RIC; also visit https://www.sirweb.org/patient-center/uterine-fibroids/