Uterine Fibroid Embolization
Fibroids are lumps of muscular tissue that can grow in and around the uterus. The tumors, which are almost always benign, can range in size from an apple seed to a grapefruit. Most are detected during a routine pelvic examination. If a physician feels a lump or mass in or near the uterus, they may order follow-up imaging for further evaluation. Cancerous fibroids (leiomyosarcomas) are rare, and scientists do not believe they arise from existing noncancerous fibroids.
Uterine fibroids are estimated to affect up to 80% of women under age 50. While the precise causes are not fully understood, some experts believe genetics and hormones may play a role in fibroid development. In many cases, the tumors grow rapidly during pregnancy, when hormone levels are high, and shrink after menopause, when hormone levels are low.
How are uterine fibroids treated?
Not all fibroids cause symptoms or require treatment, but some cause disruptive pain and heavy menstrual bleeding. A large tumor may also press on the bladder, which can lead to urinary urgency and frequency.
There are several treatment options for fibroids that cause discomfort, excessive bleeding or bladder problems. Usually, the symptoms are treated conservatively before surgery is considered. Some nonsurgical options include:
- Medications to relieve pain
- Oral contraceptives to reduce bleeding and regulate the menstrual cycle
- Intrauterine devices (IUDs) to reduce bleeding
- GnRH agonists to reduce bleeding and temporarily shrink the fibroids by blocking the production of estrogen
If the symptoms do not improve with conservative treatment, a surgical procedure may be suggested, such as a:
- Myomectomy to surgically remove the fibroids while preserving the uterus
- Hysterectomy to definitively resolve the fibroid symptoms by removing the uterus
For certain women who are considering open surgery to address symptomatic fibroids, uterine artery embolization may be a good alternative. This fertility-sparing procedure uses advanced techniques to block blood flow and oxygen delivery to problematic fibroids, which causes them to shrink over several days to several months. As a result, the associated pain, pelvic pressure, urinary issues and menstrual bleeding may be reduced.
What does uterine artery embolization involve?
Uterine artery embolization is performed in a radiology suite by an interventional radiologist. The patient is sedated but remains awake throughout the procedure. After creating a needle puncture in the femoral artery in the groin crease, the physician inserts a small catheter, guides it into the uterine arteries that supply the fibroids and takes a series of X-rays (arteriogram). Using the catheter, the physician then injects tiny plastic particles—each the size of a grain of sand—into the artery to block the flow of blood. Once the arteries are embolized, the physician will perform another arteriogram to confirm the procedure is complete.
After a uterine artery embolization, the patient will remain in the hospital overnight so their arterial access site can be monitored and they can receive pain control medications if needed. Most patients are discharged the next morning and return to full activity within a week.
The Moffitt Cancer Center difference
The Interventional Radiology team at Moffitt is proud to offer the latest treatment options for uterine fibroids, including embolization. If you would like to find out if this interventional radiology procedure is right for you, you can request an appointment with a specialist by calling 1-888-663-3488 or submitting a new patient registration form online. Moffitt does not require referrals.
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