Fibroid Embolization: Good Outcomes
85% of Women Still Better 3 Years After Uterine Fibroid Embolization
Fibroid Symptoms, Fibroid Treatments
Fibroids are benign tumors -- not cancers -- that grow inside the uterus; doctors call them uterine myomas or leiomyomata. They usually don't cause symptoms. But when they do, women may suffer excessive or painful bleeding during menstruation, bleeding between menstrual periods, abdominal pressure, frequent urination, pain during sex, and/or low back pain.
Removal of the uterus -- hysterectomy -- is the only sure way to get rid of fibroids and to make sure they never come back. Fibroids are the reason for up to 40% of the 150,000 to 200,000 hysterectomies performed each year in the U.S.
Hysterectomy results in sterility. If a woman does not want her uterus removed, and her fibroids are not too numerous or too large, she may opt for myomectomy -- removal of the fibroids.
Surgery is not the only option. The most commonly chosen nonsurgical treatment for fibroids is UFE. Other options under development include destroying fibroids via freezing, microwaves, or focused ultrasound.
During UFE, an interventional radiologist inserts a small tube into a leg artery and guides it into the blood vessels feeding the uterus. Small plastic beads released through the tube go inside the uterus and block off the blood supply feeding the fibroids. This kills the fibroids, which usually are absorbed back into the body after they die.
"The important thing is that people tend to recover more quickly after UFE than after surgery," Goodwin says. "You are talking two weeks; that is a big plus for UFE. And some studies show fewer complications than surgical alternatives."
Some women appear to do better than others. In the Goodwin study, patients who reported the best outcomes:
- Had heavy bleeding as their main fibroid symptom
- Had fewer symptoms
- Had smaller fibroids
- Were older
- Weighed less
Fibroids and Pregnancy
What if a woman needs relief from fibroid symptoms but still wants to become pregnant?
Cowan says there's only one option: myomectomy.
"If a patient with fibroids wants a pregnancy, I recommend myomectomy," Cowan says. "And not laparoscopic [minimally invasive] myomectomy, either. There might be six to 10 doctors who can do it and secure the uterus intact, but I am not one of them. And I am not willing to compromise the ultimate outcome for the patient, which is to carry a pregnancy to term."