Uterine Fibroid Embolization

Another exciting treatment for symptomatic fibroids has been available for some time and is gaining more popularity and acceptance in the medical community with each passing day. The purpose of this article is to discuss uterine fibroid embolization (UFE). Nurses Announcements Archive Article

Uterine Fibroid Embolization

Uterine leiomyomas, more commonly known as fibroid tumors, are noncancerous growths of the smooth muscle of the uterus. The most common tumor found in the female reproductive system, uterine fibroids are seen in 20-25% of all women and are estimated to occur in 40% of menstruating women older than 50 years (Siskin, 2011).

Although some patients display no symptoms, other women who have fibroids may experience pain, pelvic pressure, heavy menstrual bleeding, urinary frequency, constipation, abdominal distention, discomfort during intercourse, fertility problems, and a variety of other issues that negatively impact quality of life.

Fortunately, multiple treatment options are available for patients who suffer from fibroids. If the fibroids are relatively small and asymptomatic, the physician will usually recommend that these women follow up with frequent ultrasounds and pelvic exams. For mild symptoms, patients are sometimes prescribed birth control pills.

If the woman is moderately symptomatic, the doctor might recommend endometrial ablation or prescribe aggressive hormonal therapy such as Lupron. Women with severe signs and symptoms might be advised to undergo major surgery such as myomectomy (surgical removal of fibroids) or hysterectomy (surgical removal of the entire uterus).

Another exciting treatment for symptomatic fibroids has been available for some time and is gaining more popularity and acceptance in the medical community with each passing day. Uterine fibroid embolization (UFE), also known as uterine artery embolization (UAE), is a procedure performed by an interventional radiologist where a catheter is utilized to introduce small particles that cut off the blood supply to the dilated blood vessels that nourish the fibroids.

Once the blood supply of the hypervascular fibroid tumors has been blocked, the fibroids eventually necrose and shrink in size. The rest of the uterus maintains its blood supply due to collateral circulation.

When compared to a six-week recovery time after a hysterectomy or myomectomy, patients who undergo the UFE procedure usually recover in one week. 85 to 90 percent of women who have had UFE report either a partial or total resolution of symptoms that have affected their quality of life, and more than 90 percent say they are satisfied with the procedure.

In addition, 85 percent of women experience 40 to 70 percent shrinkage in uterine volume and fibroid volume within a year after undergoing UFE. The drawbacks of UFE include the fact that 10 to 15 percent of women do not respond to this treatment, and that up to 1 percent of procedures result in major complications such as emergency hysterectomy or premature ovarian failure. Although many women have gotten pregnant and given birth after having undergone UFE, the long term impact on fertility is not yet known.

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TheCommuter

About TheCommuter, BSN, RN

TheCommuter, BSN, RN, CRRN is a longtime physical rehabilitation nurse who has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a Registered Nurse.

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Specializes in Pediatrics and Women's Health.

Hmmm...something to think about for the future.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Personally, I underwent the UFE procedure back in 2008 at the age of 27 and the outcome was good. My symptoms started to resolve within months. Nearly four years has passed since I had the UFE performed, and I have not yet had a recurrence of the symptoms that prompted me to receive treatment in the first place.

However, I will mention that I had trouble finding an OB/GYN who would refer me to an interventional radiologist who performs UFEs. Most of the OB/GYNs that I saw had wanted me to undergo a myomectomy, but they all said that the surgery would be a high risk due to the large size and placement of my fibroids.

My mother had a myomectomy that ended up turning into an emergency hysterectomy on the operating table due to too many fibroids combined with too much blood loss, so I wanted an option that involved no major surgery.