By: Jean Johnson for Fibroids1
More than a quarter of the women alive have fibroids, although only half experience symptoms that can include pelvic pain, pain during sex, excessive vaginal bleeding, or a feeling of abdominal or pelvic fullness. For those that suffer, however, treatment options like uterine fibroid embolization (UFE) that range beyond the old gold standard of the hysterectomy are most welcome.
“I don’t know if my mom had fibroids or not, but I remember when she had her hysterectomy,” 55-year-old Betsy Simpson of Portland, Ore. said. “She was in the hospital for a week and then once she got home from the major surgery, it took forever for her to recover with all the hormonal stuff she went through.”
Hysterectomies haven’t gone the way of the dinosaur, of course. And still, one third of the women (around 200,000 patients) diagnosed with fibroids end up having hysterectomies. Still, a new generation of women can expect considerably more sophistication from the medical profession these days.
In particular UFE, a procedure that’s been around since the 1970s, but one that has more recently become well-established, is getting attention. Professor of radiology at Oregon Health Science University (OHSU), John Kaufman, MD., has performed more than 150 UFE procedures since 1997. “I think this will become a very integral part of women’s health care,” Kaufman stated on the OHSU Web site. “For some patients, it’s a very good alternative, but it’s not for all patients. We don’t like to do UFE for somebody having infertility problems related to fibroids, for example, a women desiring to have children.”
A team approach is used to determine suitability. The type, size and location of the uterine fibroids as well as the patient’s stage of life and childbearing plans go into evaluating whether or not women are candidates for UFE.
The procedure, which takes less than two hours, uses tiny plastic particles to block blood flow to the fibroid, which in turn causes the fibroid to shrink by as much as 65 percent. The particles are introduced through a catheter via a small incision in the groin. Women tend to experience moderate to severe cramping, with some experiencing more exceptional pain. Most patients prefer to remain in the hospital overnight, and pain that generally lasts for 24 to 72 hours can be controlled with medications.
Despite Kaufman’s reluctance to use UFE in women who want to have children, several patients who have undergone the procedure have had subsequent successful pregnancies. The major disadvantage of UFE is that while fibroids shrink, they do not go away completely. Thus far, though, OHSU has no reported cases in which once shrunk, fibroids grew back to original sizes.
Other options for treating fibroids include hormonal therapy such as birth control pills, progesterone and Lupron, that brings on menopausal symptoms that shrink fibroids like true menopause does. Myomectomy, or the surgical removal of a fibroid via a series of small incisions on the abdominal wall is also sometimes chosen since it removes the entire fibroid from a woman’s uterus. The less-invasive, uterine fibroid embolization, however, seems to be a method who’s day has come. And women like Betsy Simpson’s mother think it’s high time.