Procedure offers women non-surgical option for fibroid treatment

July 31, 2006
A non-surgical alternative to treat uterine fibroids, a common condition for women older than 35, has been found effective in 85 to 90 percent of women at New Hanover Regional Medical Center since 2001.

Research shows that as many as 40 percent of women older than 35 may have significantly sized fibroids growing inside their uterus. These non-cancerous tumors may cause women to experience symptoms such as heavy menstrual periods, pain in their pelvis, back or legs, pressure on the bladder or bowels, or an enlarged abdomen.

After trying conservative medical options without success, many women who experience symptoms from fibroids are hesitant to consider a complete hysterectomy. Though, it is an excellent and effective option, it’s major surgery that removes the entire uterus and eliminates the possibility of becoming pregnant.

“It comes down to helping patients make informed decisions about what’s best for them,” said fellowship-trained interventional radiologist Dr. Brian Brodwater of Uterine Fibroid Embolization. “Some have approached UFE as a bridge to try before a hysterectomy or until a patient experiences menopause.”

During menopause, estrogen and progesterone levels decrease, which causes uterine fibroids to shrink and can relieve or improve most symptoms.

“The problem is the fibroid, not the uterus,” said Dr. Brodwater, who has performed more than 250 UFE procedures. “For many women, UFE is an excellent option.”

Two of Dr. Brodwater’s patients have given birth after choosing embolization, which would not have been possible if they had opted for the hysterectomy. A hysterectomy also requires anesthesia, significantly longer recovery times and regular medications following surgery.

Uterine Fibroid Embolization is a minimally invasive technique that is performed by an interventional radiologist while the patient is conscious but sedated. It requires only a tiny nick in the skin near the groin area. The radiologist inserts a small catheter through the cut and guides it through the artery to the uterus while watching the progress and movement on moving X-ray monitor.

When the catheter is in place, tiny plastic particles the size of grains of sand are injected into the artery. The particles block the flow of blood to fibroids, depriving them of the oxygen and nutrients they need to grow. These small plastic particles have been available with the approval of the FDA for more than 20 years, and they have been proven to be safe to remain inside the body over time.

Unlike diagnostic radiology, interventional radiology involves taking x-rays of specific parts of the body such as the arteries, and intervening if a problem is identified, said John Mahosky, lead interventional technologist. Last year, more than 5,300 interventional radiology procedures were performed at NHRMC, including more than a hundred UFEs.

The UFE procedure lasts about two hours. An interventional radiologist, two technologists, and a nurse are present during the procedure. Patients usually have several hours of recovery at the hospital before going home the same day. Generally, UFEs are done on an outpatient basis and require only oral pain medication as needed afterwards.

“If they feel up to it, in a couple of days, they’re good to go,” Mahosky said.

Fibroids vary in size and are usually diagnosed during a gynecological internal exam or through ultrasound, an MRI or CT scan. The patient’s gynecologist should discuss all treatment options to determine the best course of action. If UFE is the best option, the patient will be referred to an interventional radiologist to schedule the procedure.

If you are interested in finding out more about Uterine Fibroid Embolization or other interventional radiology procedures, please call 910.343.2177.