A lot of people ask us, “what are uterine fibroids and how are they treated?” Uterine Fibroids are a benign (noncancerous) growth of the uterine wall. Their size ranges from very tiny to very large. In some cases, they can cause the uterus to grow to the size of a five-month pregnancy or more.
What are the Symptoms of Uterine Fibroids?
- Heavy, prolonged menstrual periods and unusual monthly bleeding, and sometimes clots.
- Pelvic pain, pressure, or heaviness.
- Back pain.
- Pain during sexual intercourse.
- Bladder pressure and frequent urge to urinate.
- Constipation and bloating.
- Enlarged abdomen.
Prevalence of Uterine Fibroids
Uterine fibroids are very common. 20 to 40 percent of women over the age of 35 have uterine fibroids of a significant size. African-American women are at higher risk for fibroids and as many as 50 percent have symptomatic fibroids.
How are Uterine Fibroids Diagnosed?
Fibroids are usually diagnosed during a gynecological examination. The presence of fibroids is then confirmed by an abdominal ultrasound. Magnetic resonance imaging (MRI) can be used to further assess the size, number, and location of the fibroids.
What are Your Treatment Options for Uterine Fibroids?
Many fibroids do not cause problems and do not need to be treated. When they do cause mild symptoms, birth-control pills and non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen, can provide relief in symptoms.
Myomectomy (surgical procedure)
Myomectomy involves surgically removing fibroids from the wall of the uterus. In some cases, the fibroids may grow back several years after myomectomy.
Hysterectomy (surgical procedure)
Hysterectomy involves removal of the uterus in an open surgical procedure under general anesthesia. It requires three to four days of hospitalization with a recovery period of about four to six weeks.
Uterine artery embolization, aka Uterine fibroid embolization (non-surgical procedure)
This is a minimally invasive procedure, performed by a vascular interventional radiologist, a physician who is specially trained to perform minimally invasive procedures within the inside of blood vessels. During a Uterine Fibroid Embolization, a small tube, called a catheter, is passed through a small puncture in the groin and advanced to the uterine arteries using a live X Ray, otherwise known as a fluoroscopy. Then, tiny, powder like, plastic particles are released into the uterine arteries to block to blood flow to the fibroid. This results in shrinking of the fibroid. The entire procedure is performed while the patient is conscious but sedated. The patient is also released the same day, after a few hours of observation. Many women are able to return to their normal activities within a week.
Expected Outcome of UFE
An overwhelming majority of women who undergo uterine fibroid embolization experience significant relief of symptoms. UFE is approved by the FDA, considered to be very safe, and the recurrence of treated fibroids is rare. Anticipated side effects are mild nausea and a low-grade fever. Many women experience moderate to severe cramping during the first several hours following the procedure, which can be controlled with medication. The complication rate is 1 percent, which is much lower than surgical options.
Although many women have gotten pregnant and carried full term, the long-term effects that UFE has on fertility have not been fully determined, thus the procedure is not recommended for women desiring future pregnancy.