What are uterine fibroids?

Uterine fibroids, also known as leiomyomas, are firm, compact tumors that are made up of smooth muscle cells and fibroid connective tissue, ranging from as small as a seed to as large as a melon. You can have either one or multiple fibroids, and while many experience debilitating symptoms, some do not experience symptoms at all.

Who is most likely to have fibroids?

African American women between the ages of 18-35 are most likely to develop fibroids; however, any woman can develop them during their lifetime.

What are symptoms of fibroids?

Fibroid symptoms include: heavy or prolonged periods lasting 10+ days, difficulty emptying your bladder, frequent urination, constipation, lower back or leg pain, bleeding between cycles, protruding belly/abdomen, and/or pelvic pain or pressure.

Who are at risk for Uterine Fibroids?

If the mother or sister has had fibroids, being from African American descent, started menstruating at an early age, use of birth control, obesity, a vitamin D deficiency, and diet can all affect your risk of developing fibroids.

How are fibroids diagnosed?

Most fibroids are diagnosed during a routine pelvic exam; however this is not always the case. Interventional radiologists use ultrasound technology, lab tests (a complete blood count, or CBC), MRI, Hysterosonography, Hysteroscopy, or X-Ray depending on the individual situation.

How do I know for sure that I have fibroids?

The only way to know for sure that you have fibroids is to come in for an initial consultation. After conducting an ultrasound or MRI, the interventional radiologists can determine if you have fibroids. There are some initial warning signs of fibroids; however, not all women experience the same symptoms. The warning signs are: bleeding between cycles, heavy or prolonged bleeding lasting 10+ days, intense pelvic pressure or cramping, back or leg pain, fatigue due to anemia, constipation or frequent urination, and protruding abdomen/belly.

When is treatment necessary for fibroids?

Treatment is necessary when your symptoms are interfering with your life. If you’re unable to leave the house without the fear of bleeding through your clothing, you choose to stay home instead of interacting with friends or family, you miss work due to pain or heavy bleeding, you are spending too much money on excessive feminine hygiene product use, you are constantly relying on over the counter medications to relieve pain, you feel fatigued from anemia, etc.

Is UFE an approved medical procedure?

Yes, UFE is approved by the Food and Drug Administration (FDA).

What are the benefits of Uterine Fibroid Embolization?

There are numerous benefits of choosing Uterine Fibroid Embolization (UFE). UFE allows women to skip the hospital, which can be time-consuming and expensive. With UFE, you are able to retain your uterus. Due to the fact UFE doesn’t affect your ovaries; UFE does not interfere with fertility as well. Women who choose UFE can also expect a shorter recovery. Recovery from UFE typically lasts 1-2 weeks, compared to hysterectomy which can take up to 8 weeks for full recovery. UFE also does not involve general anesthesia, or cutting into the uterus like myomectomy does. UFE takes 45 minutes from start to finish and allows you to return home after treatment.

Is an overnight stay required?

No, an overnight stay is not required for UFE. Our patients can expect the UFE treatment to take between 30-45 minutes. Following the procedure, patients will rest for about an hour to allow for the light sedative to wear off.

What type of follow up care will I need?

Before your UFE procedure, your doctor will schedule a post-op check in either by phone or in person 1-2 weeks following the treatment. Then, you will need to see your doctor at 6 months and at 1 year to monitor your progress and make sure your body is healing successfully.

Can medication be used to treat fibroids?

Over the counter medications like Ibuprofen or Aspirin can help manage pain; however it is not used as a treatment or cure. Birth control can sometimes temporarily help manage pain and heavy bleeding as well; however again, it is not considered a permanent solution to treat fibroid symptoms.

Is the procedure painful?

Every woman’s pain tolerance is different; however, most women do not report that the procedure is painful. The knick in the skin where the catheter is inserted is extremely small and does not require stitches. During treatment, your doctor will administer a light sedative so you are not uncomfortable. Our doctors work with their patients and make sure they are relaxed and ready for their treatment to minimize any discomfort.

How quickly can I go back to work?

We tell our patients that every woman and situation is different; however, you can expect to return to normal activities including work, between 1-2 weeks following your procedure. It’s important to talk to your doctor to monitor when you can exactly return to work and you’re feeling well enough. Invasive surgeries can take between 6-8 weeks for full recovery.

How do I know if I am a candidate for UFE?

The best way to know if you’re a candidate for UFE is to schedule an initial consultation. At your appointment, our interventional radiologists will use ultrasound technology to provide you with a diagnosis, and go over your medical records.

How does the UFE or UAE procedure work?

The treatment is performed as an outpatient procedure. First, our medical team makes sure you are comfortable and then our interventional radiologists will give you a light sedative to help you relax. With the help of our advanced ultrasound the fibroid/fibroids are located, this is called fibroid mapping. After numbing the upper thigh, a tiny catheter (eg; thin tube) is inserted through a very small incision. Using the ultrasound as a guide, this catheter is threaded in to the uterine artery that supplies blood to the fibroid. Small particles will flow through the catheter, and block the arteries and blood flow, this causes the fibroid to shrink. Then the catheter is removed. The incision on the thigh is so small, stitches are not required. You leave with a small bandage placed over the incision. The procedure takes approximately 30-45 minutes.

Could My Fibroids Come Back After the Treatment?

After UFE, fibroids only have a 10% chance of growing back. Due to the fact that fibroids are caused by an increase of estrogen, there are many factors which might influence fibroid re-growth. In most cases, the same fibroids will not re-grow, but new fibroids could develop depending on your individual hormones.

What complications can occur with fibroids?

One of the most common complications that can occur with untreated fibroids is anemia. Due to heavy or prolonged periods and the loss of red blood cells, anemia can sneak up and be extremely detrimental to your health. It’s important to get checked for fibroids if your periods are lasting 10+ days and you’re using more feminine hygiene products than normal.

Can I still become pregnant after UFE?

Yes, UFE is considered a good choice for women who want the option to get pregnant in the future. However, every woman and situation is different and it’s important to discuss with your doctor before treatment if that is one of your priorities. A 2017 study in the Journal of Radiology found that out of 359 women who were unable to have children due to fibroids, 149 of them after their UFE procedure were able to get pregnant. The result of the study concluded that UFE offers the chance of pregnancy to women with fibroids. Hysterectomies either remove part or the entire uterus, which makes it impossible to bear children in the future. Also, fertility issues are an associated risk of the myomectomy procedure. Even ablation therapy can cause some scarring to the uterus that can cause fertility issues.

Source: https://doi.org/10.1148/radiol.2017161495

Can Fibroids Turn Into Cancer?

Even though we call uterine fibroids “tumors”, they are almost always benign; however, there is a very small chance that fibroid can be cancerous. Less than 1 in 1,000 cases have been found to be cancerous.

Reference: “Uterine Fibroids.” Womenshealth.gov, Office on Women’s Health – U.S. Department of Health & Human Services, 16 Mar. 2018, www.womenshealth.gov/a-z-topics/uterine-fibroids.

What types of invasive surgeries are currently used to treat fibroids?

As far as invasive surgeries, there is full or partial hysterectomy, laproscopic, hysterocscopic, and abdominal myomectomy, and endometrial ablation.

We recommend trying non-surgical procedures like UFE before turning to invasive surgeries mentioned above. UFE has a high success rate and is the gold standard of fibroid treatment, allowing for the preservation of the uterus, shorter recovery, no need for general anesthesia, and no hospital stay.

Are there other effective treatments besides medication and surgery?

Yes, Uterine Fibroid Embolization (UFE) is a non-surgical, outpatient procedure for the treatment of fibroids. The benefits include: preserves the uterus and uterine functions, does not affect the ovaries, does not affect your hormones, no use of general anesthesia or hospital stay, shorter recovery, easier on the body, relatively fast procedure (30-45 minutes), and relieves associated symptoms.

Will my heavy periods improve after UFE? / Will I still get a period after the procedure?

Yes, women who undergo UFE treatment can expect both lighter and shorter periods. You can expect bleeding between cycles to cease, and you regain a more predictable, “normal” cycle. Immediately following your procedure, you may skip a period or two before your body can recover properly.

Is general anesthetic administered?

During UFE, no general anesthesia is needed. Our interventional radiologists use a light sedative (similar to the one at a doctor’s office) to help you relax. After your treatment, the incision is so tiny that only a band aid is needed.

Are there side effects?

Any medical procedure or treatment has some risk. Your doctor will go over all risk and allergy factors before your procedure. In extremely rare cases, there could be a risk associated with inserting the catheter; however this typically does not occur.

What kind of fibroids can you embolize?

We primarily treat intramural and subserosal fibroids, which are the fibroids located within the muscular uterine wall. Intramural and subserosal fibroids are the most common type of fibroids. Both Intramural and subserosal fibroids have an increased chance of affecting the woman’s ability to conceive.

Will embolization keep new fibroids from forming?

No, like any procedure, there is always a chance for new fibroids to form depending on your hormones; however, the same fibroids that were treated will not re-grow.

Is there a right age for embolization?

Yes and no. In order for you to be treated at our facilities, you must be between the ages of 18-64. There is not right age for embolization, if you’re having symptoms that are impacting your daily life, it’s important to get treatment.

What if I Become Pregnant and Have Fibroids?

Most women who have fibroids and become pregnant will go on to have normal, healthy pregnancies; however, a few complications can arise. Fibroids need estrogen to grow, which means it is unlikely that you will get fibroids during pregnancy. Some complications can be bleeding and pain. Remember to track your symptoms, and relay all information to your doctor. Unfortunately, fibroids can sometimes (rarely) cause a miscarriage. If you have multiple fibroids, the risk of miscarriage increases. Another aspect is preterm delivery. Some women with fibroids have their babies a few weeks early, which is important to monitor. See some statistics and relevant information here.

Reference: “I Have Fibroids: What Happens If I Get Pregnant?” WebMD: Women’s Health, WebMD, 2017,
www.webmd.com/women/uterine-fibroids/what-if-i-have-uterine-fibroids-while-pregnant#1.

What causes more severe symptoms in certain women?

Based on the size and location of the fibroids, symptoms can vary from nothing at all to heavy bleeding and discomfort.

Don’t Suffer Another Day

Life with fibroids can be painful and challenging. Timely detection and treatment of fibroids can relieve symptoms, as well as reduce your risk for hysterectomy.

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