Fibroids are muscular tumors that grow in the wall of the uterus. These are usually benign (non-cancerous) but if they grow substantially they can cause pain and need to be removed. Fibroids can grow as a single tumor or there can be many of them in the uterus.
Exactly what causes fibroids is not entirely clear. However, there is research that suggests these growths develop from misplaced cells present in the body before birth. The female hormones estrogen and progesterone also appear to be involved in their growth.
About 20 percent to 80 percent of women develop fibroids by the time they reach age 50. Fibroids are most common in women in their 40s and early 50s. Fibroids occur more often in African American women than in white women. They also seem to occur at a younger age and grow more quickly in African American women.
Uterine Fibroid Embolization
Interventional radiologists use uterine artery embolization as a treatment for uterine fibroids. This minimally invasive treatment is used to blocks blood flow to the fibroids. As the fibroids shrink, there is typically a dramatic decrease in abnormal uterine bleeding and related symptoms such as pelvic cramping, and abdominal distention.
Embolization of fibroids is generally well tolerated by patients and has the advantages of being able to treat all fibroids in one session and a shorter hospitalization. Uterine fibroid embolization is performed with an angiogram, or an X-ray test that uses special dye and camera to take pictures of blood flow through the uterine arteries. Potential complications of embolization of the uterine arteries include pelvic infection, inadvertent embolization of normal structures and premature menopause.
The procedure typically takes one to two hours.
- A foley catheter will be placed to drain the bladder.
- A tiny incision is usually made near an artery in the groin. This is the insertion site.
- The radiologist inserts a catheter (thin tube) through the site into an artery while viewing a video monitor.
- Contrast agent is injected into the catheter, causing a warm feeling or pressure in the area being studied.
- X-rays are taken and small particles are placed into the uterine artery. The particles will block blood flow to the fibroids.
- Polyvinyl particles are placed into the uterine artery.
- The catheter is removed and pressure is applied to the site to control bleeding.
Before your embolization, you may be requested to come to the hospital to meet the radiologist who will perform your procedure and to have blood work done.
You will be contacted by a health care provider with detailed pre-procedure instructions. As with all procedures, it is recommended that you bring all current medications in their original containers to the hospital the day of the test.
After the procedure, you are taken to your room to rest. This procedure requires an overnight hospital stay to monitor your recovery.
Pain occurs after the procedure in response to the blocked blood supply to the fibroid tissue. Pain will subside as the fibroid tissue changes. You will be provided with adequate pain medication upon discharge. Fever is related to tissue breakdown and is not indicative of infection. As vaginal bleeding stops, a brownish-gray vaginal discharge may occur. This is due to elimination of the degenerating fibroid.
When you are discharged home, you will have a small bandage over the catheter insertion site, which can be removed in one or two days.
On the day you go home, you should not drive or exercise. You should avoid bending and lifting.
Normal activities may be resumed usually within one to two weeks. Heavy lifting is avoided for two weeks or longer, depending on the ease with which you resume activities.
You will be contacted by the radiology nurse after discharge to check on your progress. Please call your referral doctor for follow-up after your next menstrual cycle.