Uterine Fibroid Embolization
Aria Health Center for Gynecology & Women's Health
|Special note on UFE, fibroids, and fertility
Fibroids themselves can cause fertility problems, but even among women with uterine fibroid symptoms, this is more often the exception than the case. Thus, the overwhelming majority of women who have these benign growths will be able to conceive and carry a normal, healthy pregnancy to term.
For a smaller percentage of women, successfully treating uterine fibroids can be a necessary step to improving fertility. However, fibroid treatment alters the uterine muscle wall in ways that may affect ability to conceive and carry through a healthy pregnancy and birth.
For women who need invasive treatment for fibroids but want to keep their ability to become pregnant, UFE offers an important new option, by providing an alternative that does not require resecting all or part of uterus. Doctors are not certain of the full effects of UFE on a woman's ability to have children. But many women who have had a UFE have subsequently become pregnant and had children without problems. There is some evidence that women who have undergone a UFE are also more likely to have complications during pregnancy or birth. Whether UFE is a contributing factor in these complications is still under study.
Thus, the nature and extent of a UFE procedure's effects on fertility are still under evaluation. UFE may not always be the procedure of choice for patients who are otherwise appropriate candidates for the procedure but who are interested in future pregnancy. Aria's specialists will discuss these questions with you, if you are under evaluation for uterine fibroids and interested in future childbearing.
Aria is one of only a handful for centers in the Delaware Valley offering the most
up-to-date procedure for correcting uterine fibroids. Awareness of uterine fibroids - of how common they are and what symptoms they can cause - has expanded among women,as this condition has received more attention in recent years, and as diagnosis and treatments for it have significantly improved. Fibroid growths in the uterus are very common, especially among women in their 30s, 40s, or older. In fact, uterine fibroids are the most common "tumors" in the female reproductive tract, and most women have them. But these masses are not cancerous, and only a fraction of women have symptoms from them. The Center for Gynecology & Women's Health at Aria Health can offer patients thorough, experienced evaluation for uterine fibroids.
The objective of care for this uncomfortable and difficult condition is symptom relief, which includes control of excessive menstrual bleeding (a symptom of fibroids that, in rare cases, can even be dangerous), cramping, and pelvic pain. Drug therapy, including hormonal medications, for fibroids is not uniformly effective. In addition, it may require a lifelong regimen of potent and expensive medications that may have side effects. Thus, treatment often focuses on directly removing or reducing the fibroids themselves, if possible.
Interventional radiologists have developed the latest approach to this goal. Called uterine fibroid embolization (UFE, or also UAE, for uterine artery embolization) this capability represents the most advanced option currently available for addressing uterine fibroid symptoms. UFE minimizes the invasiveness of directly treating fibroids. Our interventional radiologists offer this procedure and are ready to meet with you, to determine if you are a candidate for UFE.
What Are the Advantages of UFE?
Interventional radiologists perform UFE by introducing catheters through arteries in the legs and advancing them to the arteries that supply blood to the uterus. The interventionalist then injects a substance (usually tiny particles of plastic or gelatin sponge-like material) that safely forms a clot (embolizes) at these locations, thereby cutting off circulation to the uterine tissue in which the fibroid is located. After this procedure, fibroids partly or completely shrink or die off, which typically alleviates or significantly decreases symptoms.
The procedure usually requires local anesthesia and sedation only. Before and after embolizing specific uterine-artery locations, the specialists inject a contrast agent into the patient's arteries that permits them to see an exact layout of the arteries (angiography) and to maneuver the catheters into the correct position. Patients usually return home the same day or next day. They need to rest from physical or other stressful activities or exertions for a week or two after undergoing UFE. After that, they should be able to return to regular activities. Recovery from conventional surgery normally takes several times longer.
Patients have found UFE to be a desirable alternative, as the other standard option for fibroid removal is surgery to perform a myomectomy (surgical removal of fibroids) or hysterectomy. While a myomectomy keeps the uterus intact, it can be technically challenging and is not performed by all gynecologic surgical specialists. Either of these operations has much more postoperative pain, longer recover time, greater side effects, and higher risk of complications than the minimally invasive UFE intervention. And, even when performed laparoscopically (through smaller incisions, using scoping instruments), these two types of surgery require longer healing time than UFE, which is performed through a small incision at the inside of the thigh near the groin. Patients typically return to work and normal activities within
a few days of the UFE procedure.
Being able to relieve the bleeding, pain, pressure, and urinary symptoms of uterine masses, without having to use surgery and without the extended recovery required after an open or even laparoscopic operation has been a boon for women suffering from fibroids. UFE is a first-line choice for women with significant symptoms from fibrous growths in the uterus. It provides an option for millions of women who would otherwise have to live with the symptoms of uterine fibroids or consider surgery. (The likelihood of fibroids growing back after UFE appears to be modest or low, but remains under study.)
UFE at Aria
Our staff works hard to make the patient experience with uterine fibroid embolization as smooth and comprehensive as possible. Our office will establish a convenient set of dates for appointments and for the procedure, will take care of precertification for UFE with your insurer, and will coordinate your follow-up care. Our department, of course, can offer any additional imaging tests, such as various types of ultrasound studies or MR imaging, which may be needed to confirm the diagnosis, guide the procedure, and assess its results. And, we work closely, as needed, with Aria's Center for Gynecology & Women's Health to manage patients - and with fertility specialists on a consulting basis.
Most patients return home the same day of the UFE procedure or after one overnight in the hospital. Our dedicated nurse coordinator will work with you throughout the course of your care, so that you have a cohesive, personalized experience.
Patients may experience some cramping, nausea, or other discomfort after the procedure. Our staff is experienced in offering you the optimal post-procedure pain control and other relief for these side effects.
Patients generally return for a post-procedure follow up and check-ups, at one week and one month. They also return at six months and one year after the procedure for visits that include an MR imaging study.
UFE is highly successful at stopping or reducing excessive menstrual bleeding from uterine fibroids. It also decreases pain symptoms in most patients. Patient satisfaction with the UFE procedure in general, and in our UFE services at Aria in particular, is high. Patients appreciate a marked improvement in quality of life as a result of this treatment. Because awareness of UFE is still expanding among patients and health professionals, any more women could probably be benefiting from this procedure and avoiding surgery for fibroids than currently are.
For additional information about UFE, see: