333 N. Commercial Street, Suite 100
Neenah, WI 54956
Radiology Associates of the Fox Valley
Frequently Asked Questions
What are fibroids?
Uterine fibroids are very common non-cancerous (benign) growths that develop in the uterus. Fibroids range in size from small (dime sized) to extremely large (grapefruit or larger). In extreme cases, they can cause the uterus to grow to the size of a second trimester pregnancy.
As a rule, there are usually multiple fibroids in the uterus. While fibroids do not always cause symptoms, their size and location can lead to problems for some women, including pain and heavy bleeding.
One interesting fact about fibroids is that they typically shrink after menopause. It is thought that this is due to a drop in estrogen the body experiences after menopause. This is supported by the fact that some menopausal women taking estrogen do not experience relief of their fibroid-related symptoms.
UTERINE FIBROID EMBOLIZATION
Uterine Fibroid EmbolizationUterine fibroid embolization (UFE) is a procedure that was developed in the 1990’s as an alternative method for treating symptomatic uterine fibroids. There are many advantages of UFE over other treatments, including shorter recovery times with less pain, and significantly better safety. Additionally, the American College of Obstetrics and Gynecology has stated that there is good and consistent data to recommend, “based on long- and short- term outcomes, uterine artery embolization is a safe and effective option for appropriately selected women.”
Over the past 20 years, this procedure has experienced tremendous growth and is now performed regularly across the country.
Our interventional radiologists have significant experience in this procedure and offer it at the following local hospitals:
Theda Clark Medical Center - Neenah
St. Elizabeth Hospital - Appleton
Mercy Medical Center – Oshkosh
St. Agnes Hospital – Fond du Lac
How is the procedure performed?
Patients are admitted to the interventional radiology service early in the morning where an iv line is started and labs are checked. The patient is subsequently brought to the angiography suite where she is placed on a monitor and iv sedation medicines are given. Once an adequate level of sedation is achieved (this point is emphasized by our doctors), the procedure begins.
After the right hip and groin area are scrubbed, numbing medicine is injected into the right hip area surrounding the femoral artery. Then, a small (2 mm) incision is made and the femoral artery is punctured with a small needle. A wire is placed through the needle, acting as a rail for guiding catheters.
What symptoms do fibroids cause?
The location and size of the fibroids dictate they symptoms of the patient. Here are the most common symptoms:
Heavy menstrual bleeding
Bladder urgency and/or incontinence
What are the treatment options for fibroids?
High frequency focused ultrasound
Is UFE a common procedure?
Very common. More than 500,000 UFE procedures have been performed in the United States.
Is UFE safe?
Absolutely. In fact, while over 500,000 UFE procedures have been performed in the US to date, there have been only 5 deaths related to the procedure.
Do other specialists support UFE as an effective treatment for symptomatic fibroids?
The American College of Obstetrics and Gynecology released a practice bulletin on Alternatives to Hysterectomy in the Management of Leiomyomas in August of 2008 stating that there was good and consistent data to recommend, “based on long- and short- term outcomes, uterine artery embolization is a safe and effective option for appropriately selected women who wish to retain their uteri.”
Most women with symptomatic fibroids are candidates for UFE and should obtain a consult with an interventional radiologist to determine whether UFE is a treatment option for them.
Once the catheter has been introduced into the artery over the wire, it is advanced into the uterine arteries on each side of the uterus. X-ray dye is injected into the artery to confirm the correct artery has been catheterized. Subsequently, microscopic particles are injected into the uterine arteries until all small arteries supplying the fibroids are plugged up, blocking blood flow. This cuts off blood supply to the fibroids, choking them off and causing them to shrink.
Once complete, the catheter is removed from the patient’s body and firm pressure is applied to the site where the femoral artery was punctured for several minutes in order to prevent bleeding. Often times, the doctor is able to place a special plug or clip to close the artery up and allow patients to get up and move around within2 hours of completing the procedure.
What is the recovery time?
Patients are kept overnight to ensure adequate pain control and are nearly always discharged from the hospital the following morning. Nearly all patients are able to resume normal activity in 7-10 days.
Will there be much pain?
As with any procedure, there is some pain involved. However, our doctors have considerable experience in managing the pain related to fibroid embolization and are able to keep the pain related to the procedure at a minimum.
What is the success rate of the procedure?
Symptoms are successfully controlled in >90% of patients, generally near 95%.
What if I am interested in other treatment options?
Our doctors are committed to doing the best procedure for the patient. We have excellent relationships with our local OB/GYN groups and will make appropriate referrals for patients that are better suited for hysterectomy or myomectomy.