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Most women have uterine fibroids—non-cancerous, hormone-driven growths that form on the uterine walls. In fact, more than 70% of white women and 80% of black women will develop fibroids by age 49.
Fibroids can range in size from very small to very large and result in a variety of symptoms based on their size and location. Women often start developing fibroids in their 30s or 40s, and growth can continue through menopause.
More than half of patients with fibroids experience uncomfortable or painful symptoms such as:
- Abdominal bloating
- Dyspareunia (inability to orgasm)
- Pain during sex
- Pelvic pain and pressure
- Urinary frequency
- Very heavy periods
These changes aren’t a “fact of life” that women should have to deal with as we age. Effective treatments such as uterine fibroid embolization (UFE) help by stopping fibroid discomfort at the source. Through a small incision in your wrist, an interventional radiologist is able to stop blood flow to the fibroid and reduce symptoms as the fibroid shrinks and fades away.
Over the past few decades, advances in minimally invasive artery embolization have transformed UFE into a safer, more effective outpatient procedure with a quick recovery—most patients are fully recovered within two weeks.
Uterine #fibroids aren’t a ‘fact of life.’ Even small #uterinefibroids can cause heavy periods, bloating, and pain during sex. – Nora Tabori, MD: https://bit.ly/37ZpAyK.
What to expect from the UFE procedure.
When you get UFE at the Fibroid Center at MedStar Washington Hospital Center, you benefit from the expertise of both a gynecologist and an interventional radiologist – at most centers, you’ll see just one or the other. Our team meets regularly to find the best treatment option for complex cases, such as patients with multiple health issues or very big fibroids.
You will be placed under twilight anesthesia, which makes you relaxed but still able to respond to the doctor. We will sterilize the skin on either your left wrist or your groin at the hip joint and cover you with a drape. You’ll feel a small prick, which will be an injection medication to numb the skin.
The interventional radiologist will then make a small needle puncture in your wrist or groin to access the artery. Through the puncture, the doctor will insert a catheter, which is a thin tube. Using live image guidance, we will direct the catheter through the blood vessels of your arm or leg, down to the arteries that supply blood to the uterus.
From there, we will use the catheter to place small, body-safe beads into the arteries supplying the fibroids, which blocks the blood flow. Over the next few days, the fibroid tissue will start to shrink and wither away.
The last step is to place a small dressing at the artery puncture on your groin or your wrist. The entire procedure usually takes an hour or less, even when treating one large or many small fibroids.
You can get up and walk as soon as you fully come out of the twilight sedation, which takes about 30-60 minutes. As you wait, you’ll get a light snack and some pain medication, then you’ll be ready to go home. Even if you feel fully awake, we require all patients to have a ride home from the hospital.
FAQs about uterine artery embolization.
Do I have to get my fibroids removed?
No. If your fibroids don’t impact your quality of life, you don’t have to do anything about them. Leaving fibroids alone is generally safe until they grow large or numerous enough to cause disruptive symptoms.
Will the fibroid get infected if you don’t remove it?
No. This myth came about because of the old way of embolizing fibroids, which went out of practice decades ago. We used to try to kill the actual fibroid cells; cell death results in prolonged healing and increased susceptibility infection.
Modern UFE starves and shrinks fibroid tissue, which turns to dormant scar tissue. There is less risk of infection because far less, if any, as the scar tissue is sterile and retains the function of the body’s immune system. In our practice, we perform more than 100 UFE surgeries a year, and none of our patients have had an infection caused by fibroid scar tissue.
Will I be able to become pregnant after UFE?
Yes. We recommend waiting at least 12 months to make sure normal blood flow to the uterus is restored because UFE slightly alters the blood supply to the uterus. Over the next year, your body will rebuild those blood vessels to feed the remaining healthy uterine tissue.
We’ve had patients who became pregnant a few months after UFE and had healthy babies. However, waiting is the safest choice. Having UFE does not limit your birth control choices. You can use whatever contraceptive you’d like, including an intrauterine device (IUD).
Is recovery from UFE painful?
Pain in recovery is typically mild. For the first two days after the procedure, you may experience cramps that feel a little stronger than period cramping. Most patients can manage this side effect with over-the-counter or prescribed pain medication. You may also have these symptoms, which typically go away within a week:
- Slight pelvic pain
- Pelvic fullness
- Low-grade fever
- Slight loss of appetite
- Mild fatigue
By seven days post-procedure, most women are back to their regular activities: Working, resuming intercourse, running a marathon, doing CrossFit, you name it! After UFE treatment, countless patients have told me, “I wish I’d done this years ago.”
Uterine fibroids rarely grow back after embolization. However, new fibroids may grow over time. If you want a more permanent treatment, options are available.
Other treatment options besides UFE.
Your MedStar Health gynecologist and interventional radiologist will discuss all your fibroid treatment options so you can make an informed decision. You know your body and future plans better than anyone, and our specialists want you to be happy with your choice.
- Myomectomy: Removing the fibroids from your uterus. Myomectomy may be done through open or minimally invasive surgery and spares fertility.
- Endometrial ablation: Applying targeted heat to the uterine lining to reduce heavy bleeding during your period. This outpatient option does not remove or shrink fibroids. Endometrial ablation greatly reduces your ability to become pregnant.
- Hysterectomy: Removing your uterus through open or minimally invasive surgery. After a hysterectomy, you will not have periods anymore and you will not be able to become pregnant.
Non-surgical options to manage symptoms.
Pregnancy is possible after these treatments:
- Sonata Treatment: This ultrasound treatment locates and targets individual fibroids. Using radiofrequency energy, we shrink the fibroids from inside the uterus with no incisions.
- Pain relievers: Over-the-counter or prescribed pain medication can help you manage cramping or pain.
- Hormone therapy: Estrogen and progestin medications such as birth control pills or an IUD may help shrink fibroids. Ulipristal acetate, which is used in the “morning-after pill” may also help shrink fibroids.
- Exercise and eating well: While neither of these will change the size of your fibroids, moving more and eating a healthy diet can help you feel more energetic, maintain a healthy weight and hormone levels, and improve your mood—all important factors in managing a painful condition such as fibroids.
- Complementary medicine: Practicing relaxation techniques such as meditation and deep breathing are known to reduce pain. Doing yoga or tai chi may help alleviate fibroid pain that affects the lower back.
Uterine fibroid symptoms range from annoying to nearly debilitating. You have options to improve your quality of life—the treatment you choose is based on the severity of your symptoms and your desire for future pregnancies.
Whether you need a diagnosis or you already know which treatment you want, MedStar Health can provide you with the option that best meets your needs.