New application for an old technique
Emory Healthcare is offering women who suffer with uterine fibroids a nonsurgical treatment.
Many women who have uterine fibroids go through their days with no noticeable symptoms.
They may even be unaware they have fibroids at all. However, for a small percentage who have symptoms, daily life can be interrupted continually by pain.
Uterine fibroids can cause a host of disruptive symptoms: unusually heavy or long menstrual periods, pain during sexual intercourse, pressure on the bladder leading to frequent trips to the bathroom, bloating, and pain in the pelvis, legs, or lower back. They affect 20% to 40% of women 20 years or older and occur in half of African American women. So far, doctors are unable to pinpoint why fibroids are more common in African Americans or why women develop them at all. But they do know that heredity and obesity are factors.
Women with problematic uterine fibroids traditionally have had only two options—a hysterectomy or a myomectomy (surgical removal of the fibroids). In fact, unwanted fibroid symptoms trigger approximately 150,000 hysterectomies each year.
Recently, an old technique is providing women who suffer with uterine fibroids with a nonsurgical alternative. Physicians have used embolization for more than two decades to treat pelvic bleeding or trauma, and now they are using the procedure to shrink uterine fibroids too.
"If a gynecologist has offered a hysterectomy, a women should look into uterine fibroid embolization," says Emory interventional radiologist Gail Peters. "The procedure is less invasive, better tolerated, and requires less time for recuperation."
Although the American College of Obstetricians and Gynecologists recognizes embolization as a viable treatment for uterine fibroids, Peters says that some doctors are failing to talk to women about the option. "Most women come to me on their own and are looking for an alternative to surgery," she says
What she tells them is that embolization offers fewer complications and a quicker recovery than surgical options. It has an 85% to 92% success rate compared with myomectomy, after which 10% to 30% of patients develop fibroids again. And women who experience embolization can forego the three- to four-day hospital stays and four to six weeks of recovery that accompany hysterectomies.
An embolization is performed through a small puncture in a groin artery. Dye is injected into the artery to identify which blood vessels supply the uterus and fibroids. The radiologist then guides a wire and catheter into the identified vessels and injects small particles that block the blood supply to the fibroids. The fibroids and the uterus shrink approximately 60% in the first year. Heavy periods usually take a few cycles to lessen. The procedure takes approximately an hour followed by a day’s stay in the hospital for intravenous pain medication. Patients usually can resume normal activity after a week.
"Most of the women I’ve treated report a significant improvement in their symptoms at their first-month check-up," Peters says.
For more information or to schedule an appointment, please call 404-712-7033, or visit emoryhealthcare.org/ufe.