Uterine fibroids, medically referred to as leiomyomas or myomas, are non-cancerous tumors that develop in or around the uterus, a key organ in the female reproductive system. These growths are incredibly common, particularly among women of childbearing age, with studies suggesting that up to 80% of women will develop fibroids at some point in their lives. Despite their benign nature, fibroids can cause a variety of symptoms that significantly affect a woman’s quality of life.

A new treatment for fibroids without surgery : uterine artery embolization

Uterine Fibroid Embolization (UFE) is a minimally invasive treatment option that is increasingly being used to manage symptomatic fibroids. It is particularly suitable for women who wish to avoid surgery or who are not candidates for more invasive procedures.

1. Procedure: UFE is performed by an interventional radiologist. The procedure begins with a small incision, usually in the groin, where a catheter is inserted into the uterine artery. Using X-ray guidance, the catheter is positioned near the fibroids, and small particles are injected to block the blood flow to the fibroids. Without a blood supply, the fibroids shrink and die over time.
2. Recovery: The procedure typically lasts 1-2 hours, and most women can go home the same day. Recovery time is much shorter than for surgical options, with most women returning to normal activities within a week.
3. Effectiveness: UFE is highly effective, with about 85-90% of women experiencing significant improvement in symptoms. It also preserves the uterus, making it a good option for women who wish to maintain fertility.
4. Long-Term Outcomes: Studies have shown that UFE provides durable relief from fibroid-related symptoms, and many women report an improved quality of life. Although the procedure is effective in shrinking fibroids, it’s essential to note that it doesn’t eliminate them entirely. In some cases, fibroids may regrow, although this is relatively rare.

What are the benefits of Uterine Fibroid Embolization ?

Uterine Fibroid Embolization (UFE) offers several benefits, making it a valuable alternative to surgical treatments for uterine fibroids. Here are the key benefits:

1. Minimally Invasive: UFE is a non-surgical procedure that involves inserting a catheter through a small incision, which reduces recovery time and minimizes surgical risks.
2. Quick Recovery: Most patients can return to normal activities within 1-2 weeks, which is much faster than recovery from major surgery like a hysterectomy.
3. Effective Symptom Relief: UFE significantly reduces symptoms associated with fibroids, such as heavy menstrual bleeding, pelvic pain, and pressure.
4. Preservation of Uterus: Unlike a hysterectomy, UFE does not involve the removal of the uterus, making it a preferable option for women who want to keep their reproductive organs.
5. Less Pain and Fewer Complications: Because it is minimally invasive, UFE typically causes less post-procedure pain and has fewer risks of complications compared to more invasive surgeries.
6. Shorter Hospital Stay: UFE is usually performed as an outpatient procedure or requires only a short hospital stay, reducing the overall time spent in the hospital.
7. Reduced Risk of Fibroid Recurrence: UFE has a low risk of fibroid recurrence because it blocks the blood supply to fibroids, causing them to shrink over time.
8. Potential for Pregnancy: While UFE may affect fertility in some cases, many women have successfully become pregnant after the procedure. UFE preserves the uterus, offering a potential option for those wishing to conceive, although it’s important to discuss fertility goals with a specialist prior to the procedure.

What are uterine fibroids ?

Uterine fibroids can vary greatly in size, from as small as a pea to as large as a melon. They can grow as a single nodule or in clusters, and their size and location within the uterus can determine the type and severity of symptoms a woman may experience. Fibroids are classified based on their location:

1. Intramural Fibroids: These are the most common type and develop within the muscular wall of the uterus. They can grow large and stretch the womb.
2. Submucosal Fibroids: Located just beneath the lining of the uterine cavity, these fibroids can protrude into the uterine cavity and cause severe bleeding and other symptoms.
3. Subserosal Fibroids: Found on the outer wall of the uterus, subserosal fibroids can press against neighboring organs like the bladder or the bowel, leading to symptoms such as frequent urination or constipation.
4. Pedunculated Fibroids: These fibroids grow on small stalks or stems inside or outside the uterus. They can cause sharp pain if the stalks twist.

Causes and risk factors of uterine fibroids

The precise cause of uterine fibroids is still not entirely understood, but several factors are known to contribute to their development:

– Hormonal Factors: Estrogen and progesterone, hormones that stimulate the growth of the uterine lining during each menstrual cycle, appear to promote the growth of fibroids. Fibroids tend to shrink after menopause, when hormone levels drop.
– Genetics: A family history of fibroids increases the likelihood of developing them. Specific genetic changes have been found in many fibroids, distinguishing them from normal uterine muscle cells.
– Ethnicity: African-American women are more likely to develop fibroids, and they tend to have more severe symptoms at an earlier age compared to women of other ethnic groups.
– Obesity: Higher body weight is associated with an increased risk of fibroids, possibly due to higher levels of estrogen in the body.
– Diet: A diet high in red meat and low in green vegetables, fruit, and dairy may increase the risk of fibroids. Alcohol consumption, particularly beer, also seems to increase the risk.
– Environmental Factors: Recent studies suggest that exposure to certain environmental toxins, such as those found in some hair relaxers and endocrine-disrupting chemicals, may contribute to the development of fibroids.

What are the symptoms of fibroids ?

Not all women with fibroids experience symptoms; however, for those who do, the symptoms can be severe and debilitating. The most common symptoms include:

– Heavy Menstrual Bleeding: One of the most frequent symptoms, heavy bleeding can lead to anemia, characterized by fatigue, weakness, and paleness.
– Pelvic Pain and Pressure: As fibroids grow, they can cause a feeling of fullness or pressure in the pelvic area, sometimes leading to severe pain.
– Frequent Urination: Fibroids pressing on the bladder can cause an increased need to urinate or even urinary incontinence.
– Constipation: Large fibroids can press on the rectum, causing discomfort and difficulty in bowel movements.
– Pain During Intercourse: Particularly with fibroids located near the cervix, sexual intercourse can become painful.
– Complications in Pregnancy: Fibroids can interfere with conception and pregnancy, increasing the risk of miscarriage, preterm birth, or complications during delivery.

Diagnosis of uterine fibroids

Diagnosing uterine fibroids typically involves a combination of medical history, physical examination, and imaging tests:

– Pelvic Examination: During a pelvic exam, a healthcare provider may feel irregularities in the shape of the uterus, which may suggest the presence of fibroids.
– Ultrasound: This imaging technique uses sound waves to create a picture of the uterus, helping to confirm the presence, size, and location of fibroids.
– Magnetic Resonance Imaging (MRI): MRI can provide a more detailed image and is particularly useful in cases where surgery is being considered.
– Hysterosonography: Also known as a saline infusion sonogram, this test involves injecting sterile saline into the uterine cavity to expand it, making it easier to see fibroids inside the uterus.
– Hysteroscopy: This involves inserting a small, lighted telescope through the cervix into the uterus to examine the lining and remove fibroids if necessary.