Uterine Fibroid Treatment

 (UFE)

Fibroid Freedom

In August 2008, the American College of Obstetricians and Gynecologists (ACOG) endorsed Uterine Fibroid Embolization (UFE) as a "safe and effective" treatment option for uterine fibroids. UFE is a minimally invasive procedure that offers women significant benefits before considering a hysterectomy.

UFE is recommended for most women with symptomatic fibroids, providing a non-surgical alternative that preserves the uterus. Women seeking alternatives to surgery should consult with one of our radiologists to explore UFE as a viable treatment option tailored to their individual needs.

What To Expect

Signs & Symptoms

  • Heavy, prolonged menstrual periods and unusual monthly bleeding, sometimes with clots. This can lead to anemia.
  • Pelvic pain and pressure
  • Pain in the back and legs
  • Pain during sexual intercourse
  • Bladder pressure leading to a frequent urge to urinate
  • Pressure on the bowel, leading to constipation and bloating
  • Abnormally enlarged abdomen



Initial Consultation

During your initial visit you will meet with our radiologist to discuss your symptoms and medical history. This consultation is an opportunity to explore a minimally invasive treatment option for uterine fibroids. The radiologist will review any records and may schedule an MRI if you do not have one already. Our goal is to ensure you feel informed and confident in your decision regarding fibroid treatment.

Treatment Plan

Uterine Fibroid Embolization (UFE) is a minimally invasive procedure used to treat uterine fibroids. It involves blocking the blood vessels that supply the fibroids, causing them to shrink and alleviate symptoms such as heavy menstrual bleeding and pelvic pain.  This minimally invasive procedure is done in office using imaging to visualize arteries to the fibroids. UFE preserves the uterus and offers a quicker recovery compared to traditional surgery.

Post Treatment

Patients can go home 4 hours after the procedure. Patients may experience some bruising or soreness at the catheter insertion site. As well as intense cramping in the first 72 hours post procedure. Rest and avoid strenuous activities for a few days to aid healing. Keep the insertion site clean and dry, and monitor for any signs of infection, such as redness or swelling. A nurse will call the next day to check in. Initial follow-up visit is scheduled 2-4 weeks, 6 months, and 1 year after your procedure.

Post Procedure Instructions

Highly effective, widely available Interventional Radiology Treatment often replaces need for Hysterectomy

Uterine fibroids are very common non-cancerous (benign) growths that develop in the muscular wall of the uterus. They can range in size from very tiny (a quarter of an inch) to larger than a cantaloupe. Occasionally, they can cause the uterus to grow to the size of a five-month pregnancy. In most cases, there is more than one fibroid in the uterus. While fibroids do not always cause symptoms, their size and location can lead to problems for some women, including pain and heavy bleeding.

Fibroids can dramatically increase in size during pregnancy. This is thought to occur because of the increase in estrogen levels during pregnancy. After pregnancy, the fibroids usually shrink back to their pre-pregnancy size. They typically improve after menopause when the level of estrogen, the female hormone that circulates in the blood, decreases dramatically. However, menopausal women who are taking supplemental estrogen (hormone replacement therapy) may not experience relief of symptoms.

Uterine fibroids are the most common tumors of the female genital tract. You might hear them referred to as “fibroids” or by several other names, including leiomyoma, leiomyomata, myoma and fibromyoma. Fibroid tumors of the uterus are very common, but for most women, they either do not cause symptoms or cause only minor symptoms.

Subserosal Fibroids
These develop under the outside covering of the uterus and expand outward through the wall, giving the uterus a knobby appearance. They typically do not affect a woman’s menstrual flow, but can cause pelvic pain, back pain and generalized pressure. The subserosal fibroid can develop a stalk or stem-like base, making it difficult to distinguish from an ovarian mass. These are called pedunculated. The correct diagnosis can be made with either an ultrasound or magnetic resonance (MR) exam.

Intramural Fibroids
These develop within the lining of the uterus and expand inward, increasing the size of the uterus, and making it feel larger than normal in a gynecologic internal exam. These are the most common fibroids. Intramural fibroids can result in heavier menstrual bleeding and pelvic pain, back pain or the generalized pressure that many women experience.

Submucosal Fibroids
These are just under the lining of the uterus. These are the least common fibroids, but they tend to cause the most problems. Even a very small submucosal fibroid can cause heavy bleeding – gushing, very heavy and prolonged periods.

Prevalence of Uterine FibroidsTwenty to 40 percent of women age 35 and older have uterine fibroids of a significant size. African American women are at a higher risk for fibroids: as many as 50 percent have fibroids of a significant size. Uterine fibroids are the most frequent indication for hysterectomy in premenopausal women and, therefore, are a major public health issue. Of the 600,000 hysterectomies performed annually in the United States, one-third are due to fibroids.


Uterine Fibroid Symptoms

Most fibroids don’t cause symptoms—only 10 to 20 percent of women who have fibroids require treatment. Depending on size, location and number of fibroids, they may cause:

 

  • Heavy, prolonged menstrual periods and unusual monthly bleeding, sometimes with clots. This can lead to anemia.
  • Pelvic pain and pressure
  • Pain in the back and legs
  • Pain during sexual intercourse
  • Bladder pressure leading to a frequent urge to urinate
  • Pressure on the bowel, leading to constipation and bloating
  • Abnormally enlarged abdomen

 


Imaging Expertise Enables Interventional Radiologists to Provide Gynecologists

and Their Patients Better Diagnosis and Nonsurgical Treatment Options

Women typically undergo an ultrasound at their gynecologist’s office as part of the evaluation process to determine the presence of uterine fibroids. It is a rudimentary imaging tool for fibroids that often does not show other underlying diseases or all the existing fibroids. For this reason, MRI is the standard imaging tool used by interventional radiologists.


Magnetic resonance imaging (MRI) improves the patient selection for who should receive nonsurgical uterine fibroid embolization (UFE) to kill their tumors. Interventional radiologists can use MRIs to determine if a tumor can be embolized, detect alternate causes for the symptoms, identify pathology that could prevent a women from having UFE and avoid ineffective treatments. Using an MRI rather than ultrasound is like listening to a digital CD rather than a record – the quality is better in every way. By working with a patient’s gynecologist, interventional radiologists can use MRIs to enhance the level of patient care through better diagnosis, better education, better treatment options and better outcomes.

UFE Facts


  • On average, 85-90 percent of women who have had the procedure experience significant or total relief of heavy bleeding, pain and/or bulk-related symptoms.


  • Recurrence of treated fibroids is very rare. Short and mid-term data show UFE to be very effective with a very low rate of recurrence. Long-term (10-year) data are not yet available, but in one study in which patients were followed for six years, no fibroid that had been embolized regrew.


  • An estimated 13,000-14,000 UFE procedures are performed annually in the U.S. (as of 2004)


  • Embolization has been used to treat tumors since 1966. Embolization to treat uterine fibroids has been performed since 1995 and the embolic particles are approved by the FDA specifically to treat uterine fibroid tumors, based on comparative trials showing similar efficacy with less serious complications compared to hysterectomy and myomectomy (the surgical removal of fibroids).


  • Embolization of fibroids was first used as an adjunct to help decrease blood loss during myomectomy. To the surprise of the initial users of this method, many patients had spontaneous resolution of their symptoms after only the embolization and no longer needed the surgery.

Office Referring a UFE to MVI

What you need to send:


  1. Patient Demographics: Name, date of birth, contact information, and insurance details.
  2. Medical History: Including relevant details about the patient's gynecological and overall health history.
  3. Diagnostic Imaging: Recent ultrasound reports to confirm the presence and location of uterine fibroids. MRI reports may also be beneficial for detailed assessment, if patient has already had one.
  4. Biopsy Results (if applicable): Any histopathology reports related to uterine fibroids or other relevant conditions.
  5. Recent Pap Smear Results: Documentation of the patient's last Pap smear to ensure current gynecological health status.
  6. Clinical Notes: Any additional notes or reports from previous consultations or treatments related to uterine fibroids or gynecological concerns.

Having these records available will help ensure a comprehensive evaluation and appropriate treatment planning for the patient seeking UFE.


Please fax referral to (615)890-7838. Once referral is sent, we will call patient to schedule a consultation.

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