Minimally Invasive Procedure Effective for Treating Fibroids in Some Women


By Heather Maloney
Beth Israel Deaconess Medical Center staff


A minimally-invasive procedure has been shown to successfully treat uterine fibroids while requiring little downtime for the patient and preserving the woman’s uterus.


“This is another treatment option for women to consider,” says Dr. Yvonne Gomez-Carrion, an obstetrician and gynecologist at  Beth Israel Deaconess Medical Center Boston and Assistant Professor of Obstetrics and Gynecology at Harvard Medical School. “It’s a great option for a woman who is an appropriate candidate and doesn’t want to have surgery.”


Called uterine fibroid embolization (UFE), this non-surgical procedure is performed while the patient is conscious but sedated, and typically requires only an overnight hospital stay. An abdominal hysterectomy, the traditional treatment for fibroids, typically requires a hospital stay of one to two days and a recovery period of about two weeks, compared to six weeks if performed laparoscopically versus an open incision. Also, a total hysterectomy removes the entire uterus, while UFE does not involve any uterine surgery. During a UFE, the major blood supply to a dominant fibroid is blocked, which can cause shrinkage of the uterine fibroid, often resulting in symptom relief.


Fibroids are tumors made up of muscle cells and other tissue that grow within the wall of the uterus. According to the National Institutes of Health, uterine fibroids are the most common non-cancerous tumors in women of childbearing age.


Most fibroids don’t cause any discomfort; only about 10 to 20 percent of women who have fibroids require some form of treatment. Depending on the location, size and number of fibroids, a patient may experience heavy, prolonged menstrual periods and unusual monthly bleeding, pressure on the bladder or bowel, an abnormally enlarged abdomen, pelvic pain, and pain during sexual intercourse.


In UFE, also referred to as uterine artery embolization (UAE), polyvinyl alcohol (PVA) particles are injected into uterine arteries through a catheter. These particles build up in the targeted arteries and block blood flow to the fibroid. The doctor, usually an interventional radiologist, makes a small incision (usually in the groin area) and inserts a thin, flexible tube. The pellets block the vessels supplying blood to the fibroids, cutting off their blood supply and causing them to die.


While this procedure does preserve the uterus, it is not recommended for women who wish to get pregnant.


“It’s not advised for women who want to have children,” says Dr. Gomez-Carrion. “It could change the wall of the uterus, which could create an area of weakness that could potentially rupture with a pregnancy.”


The medical literature on pregnancy after this procedure is very limited, and thus it is still considered investigational for patients who may want to become pregnant.


The procedure has other risks as well.


“UFE can put you into an earlier menopause, though that can be a positive for some women who have been experiencing extreme symptoms with their fibroids,” says Dr. Gomez-Carrion.


And, though small, there is also the risk of infection.


Dr. Gomez-Carrion points out that UFE is not an option for every patient. If you suffer from uterine fibroids, she advises that you discuss all of the options with your doctor.


Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.