Uterine Fibroid Embolization

What are Uterine Fibroids?

Uterine fibroids also known as myomas, are non-cancerous growths that develop in or around the uterus. They are composed of muscle and fibrous tissues and can vary in size, ranging from very small to several inches in diameter. They can develop inside the uterine cavity, within the uterine wall, or on the outer surface of the uterus. Uterine fibroids are very common, that approximately 50% of middle aged women are estimated to suffer from this condition.

Causes Of Uterine Fibroids

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Hormones
Estrogen and progesterone, hormones that are associated with the regulation of menstrual cycle seem to stimulate the growth of fibroids. Fibroids tend to grow during reproductive years when hormone levels are high and usually shrink after menopause when hormone levels decrease.
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Genetic factors
Studies have shown that some women could be more likely to develop fibroids than others, the reason being genetic predisposition. History of fibroids: If a close family member (mother, sister) has had uterine fibroids, you may be at higher risk of developing them as well.
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Other growth factors
Other substances that help maintain tissues, such as insulin-like growth factor (IGF), might affect fibroid development.

Symptoms of Uterine Fibroids

  • Heavy menstrual bleeding (menorrhagia)

    This is the most common symptom. Women may experience prolonged or heavy periods, with blood clots.

  • Menstrual pain

    Fibroids cause severe menstrual cramps (dysmenorrhea) that may be more intense than usual.

  • Pelvic pressure or pain

    Fibroids can cause a feeling of heaviness in the pelvic area. Some women may have pelvic pain or discomfort.

  • Urinary symptoms

    Large fibroids can lead to frequent urination or even a sense of urgency to urinate.

  • Constipation or bloating

    Fibroids may result in difficulty passing stool or a sensation of fullness and bloating.

  • Pain during intercourse

    Fibroids may bring about pain or discomfort during sexual intercourse.

  • Abdominal swelling

    In some cases, large fibroids can cause the abdomen to enlarge, giving the appearance of pregnancy.

  • Infertility or pregnancy complications

    Fibroids can potentially hinder fertility or cause problems during pregnancy, such as miscarriage or premature labor.

Treatments for Uterine Fibroids

The treatment options are individualized depending on the circumstances and it is therefore important to consult our Consultant, so that you can determine the most suitable option based on your symptoms, overall health, and reproductive plans.

Medications

Painkillers: Painkillers like ibuprofen or acetaminophen can help relieve pain and discomfort.

Hormonal therapy: Birth control pills, hormonal IUDs (intrauterine devices), or hormone therapy can help to normalize heavy bleeding and reduce symptoms.

Gonadotropin-releasing hormone (GnRH) agonists: These drugs shrink fibroids by stopping the production of hormones that encourage their growth. They are usually used for a short period because of their side effects which include causing menopause-like symptoms.

Minimally Invasive Procedure

Uterine Fibroid Embolization (UFE): It involves blocking the blood supply to fibroids, causing them to shrink.

MRI-guided focused ultrasound surgery (FUS): Fibroids are destroyed through high-energy ultrasound waves.

Surgical and other treatment options

Myomectomy: Surgery to remove fibroids while leaving the uterus intact, which is an option for women who want to preserve their fertility.

Hysterectomy: Surgical removal of the uterus, which is a definitive treatment for fibroids. However, this eliminates the possibility of future pregnancy.

Endometrial AblationThis procedure destroys the lining of the uterus and is used to control heavy bleeding in women with small fibroids within the uterus.

MyolysisDuring this laparoscopic procedure, electric current or freezing is used to destroy the fibroids.

Uterine Fibroid Embolization (UFE)

Transformative Treatment Option for Fibroids

Uterine Fibroid Embolization (UFE) is a minimally invasive procedure used to shrink fibroids and alleviate symptoms while preserving the uterus. The procedure involves the following steps:

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Patient Preparation

The patient will be evaluated prior to the procedure which may include imaging techniques such as ultrasound scan and MRI, in order to locate and determine the size and number of fibroids. Before the procedure, the patient will be given medications to help prepare for it, such as antibiotics to prevent an infection.
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Catheter Insertion

Through a small incision into the wrist, the doctor threads a narrow tube (called a catheter) up to an artery. The catheter is guided under imaging to the blood vessels that supply blood to the uterus.

Embolization

Once the catheter is positioned, small particles (embolic agents) are injected through the catheter into uterine arteries that supply blood to fibroids. This will restrict blood flow to fibroids, due to which they ultimately shrink and die off. Embolization agent typically used is polyvinyl alcohol (PVA) particles.

Recovery

At the completion of the procedure, the catheter is removed and pressure is applied to the site in order to prevent bleeding. The patient will be monitored for a few hours before being discharged. Most patients can go home after an overnight stay.

Benefits of UFE

Frequently asked Questions

Are uterine fibroids common?

Fibroids are quite common with around 2 in 3 women developing one fibroid at some point in their life. They most often occur in women aged 30 to 50. Approximately 50% of middle aged women are estimated to suffer from this condition.  

What are the risk factors for fibroids?

There are few known risk factors for uterine fibroids, some of which are as follows:

Obesity.Family history of fibroids.Getting your period at a young age (typically before the age of 10).Vitamin D deficiency.A diet higher in red meat and lower in green vegetables, fruit and dairy.Drinking alcohol.No history of pregnancy.Late age for menopause.

Are fibroids cancerous?

It is extremely rare for uterine fibroids to become cancerous. Fibroids are malignant in less than 1 out of 1000 cases, and these malignancies are referred to as uterine sarcomas. This type of cancer starts in the muscular or connective tissues of the uterus, unlike the much more common endometrial cancer that starts in the lining of the uterus.

Can fibroids harm my pregnancy?

Many patients with fibroids have safe pregnancies. Nevertheless, the number, location and size of fibroids can influence pregnancy outcomes. Some patients suffering from uterine fibroids may give birth prematurely while others may need to undergo a caesarean section. Additionally, fibroids have been associated with miscarriages.

Do fibroids go away on their own after pregnancy?

In certain instances, fibroids may shrink or reduce in size after pregnancy, especially after menopause or following hormonal changes that occur postpartum. However, the likelihood of fibroids completely disappearing without any intervention is generally low. 

Do fibroids make my stomach big?

Yes, fibroids can contribute to a feeling of abdominal bloating or distension, which may make the stomach appear larger.

What happens when fibroids are left untreated?

There are several potential consequences from untreated fibroids, depending on the size, number, and location of the fibroids, as well as individual factors such as age and overall health. Some common complications of untreated fibroids include heavy menstrual bleeding, pelvic pain or pressure, frequent urination, constipation, and back or leg pain, anemia, infertility or difficulties conceiving, pregnancy complications etc. Over time, these symptoms may worsen. Early intervention by our experienced medical practitioner can help alleviate symptoms, prevent complications, and improve quality of life.

Are fibroids dangerous?

In general, fibroids are not considered dangerous. But they can cause pain, and they may lead to complications. Fibroid symptoms such as heavy menstrual bleeding, may sometimes cause other complications such as anemia.

What does uterine fibroid pain feel like?

The following are some common descriptions of the types of pain women with uterine fibroids may experience:

Pelvic pain or pressure.Menstrual pain.Pain during or after sexual intercourse.Bladder or bowel pain.Acute pain from fibroid degeneration (necrosis).Back or leg pain.

Can uterine fibroids develop after menopause?

While uterine fibroids are most common during the reproductive years (between the ages of 30 and 50), they can indeed develop or persist even after menopause. However, their growth will usually be slower and they tend to become less symptomatic over time.

How are fibroids diagnosed?

Usually, a combination of imaging techniques, physical examination, and medical history is used to identify fibroids. 

Medical History : Our consultant will ask about your symptoms, menstrual history, and any other medical conditions. Heavy menstrual bleeding, pelvic pain or pressure, frequent urination, constipation, and infertility are the symptoms that are frequently linked to fibroids. Physical Examination : During a pelvic examination, the doctor may feel for abnormalities in the shape or size of your uterus, which could indicate the presence of fibroids. However, not all fibroids are detectable this way.Ultrasound : The most common imaging test for diagnosing fibroids is ultrasound. The size, quantity, and position of fibroids can all be determined via transvaginal ultrasonography, which also offers detailed pictures of the uterus.MRI (Magnetic Resonance Imaging): It can be used to provide more specific information, like the exact location of fibroids or evaluating their impact on nearby structures.Hysterosonography : In order to improve visibility of fibroids inside the uterus cavity (submucosal fibroids), saline is injected into the uterus during ultrasound imaging.Laparoscopy : During this test, our health care provider will make a small cut (incision) in your lower abdomen. A thin and flexible tube with a camera on the end will be inserted to look closely at your internal organs.

Is Uterine Fibroid Embolization (UFE) an effective procedure?

Uterine Fibroid Embolization is very effective procedure with nearly 90% success rate. Most individuals who undergo UFE procedure experience remarkable reduction or complete resolution of their fibroid-related symptoms. 

Can UFE treat multiple fibroids at once?

Yes, UFE is an effective treatment for multiple fibroids in the uterus. UFE can treat several fibroids simultaneously, regardless of their size or location within the uterus. 

Will my insurance cover UFE procedure?

UFE is covered by insurance plan. However, the level of coverage may vary based on the specific plan. It would be better to ascertain from our coordinators and the insurance provider if it is covered and about any out-of-pocket fees.

Who cannot do UFE procedure?

Patients who have cervical/endometrial/uterine cancer or women with an active, recent or chronic pelvic infection cannot undergo UFE procedure.

Will UFE affect my fertility?

No, UFE procedure will not adversely affect your fertility. UFE preserves and in some cases enhances fertility among women of normal childbearing age.

Are routine medications safe to take prior to UFE?

Prior to UFE, it is generally safe take routine medications. However, some medications like blood thinners are recommended to be discontinued for a few days prior to the procedure. Our Consultant will assess all your medications and give advice on whether you need to discontinue any medication prior to the procedure.

Is UFE procedure painful?

You will not feel any pain during the procedure. However, you may feel some cramping post procedure. 

When can I go back to work after UFE procedure?

The recovery period for UFE is very brief. You might be able to go back to work within 3-7 days following the treatment.

Does the UFE procedure require a hospital stay?

You will be allowed to go home on the next day of the procedure, provided your condition is deemed appropriate for discharge by our healthcare team.

Can Fibroids Grow Back After UFE?

Studies show that it is very rare for a treated fibroid to regrow or for new fibroids to develop after UFE procedure. Despite the fact that the embolic agents' blockage is only temporary, fibroids typically die off before any blood flow is restored.

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