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Non-Surgical Procedure to Treat Uterine Fibroids

Up to 75 percent of all women will have uterine fibroids during their lifetime, usually after the age of 35. Fortunately, nearly half of all women with fibroid tumors will not experience any symptoms of this common disorder, which causes non-cancerous growths in the uterus.

However, some patients may require treatment to manage more severe symptoms, including pain, abnormally heavy bleeding, bowel and bladder problems and even infertility.

Women seeking treatment for troublesome uterine fibroids now have the option of undergoing a non-surgical, uterus-sparing treatment offered at Saint John’s Health Center. This procedure, called uterine fibroid embolization (UFE), is a minimally invasive treatment performed by Saint John’s interventional radiologists that shrinks fibroid tumors in the uterus by blocking the uterine artery supply to the fibroids.

“Although UFE has been used to treat uterine fibroids for only the past eight years, uterine artery embolization has been used for more than 30 years to treat life-threatening bleeding from the uterus,” says Louis Adler, M.D., an interventional radiologist at Saint John’s who has performed hundreds of these procedures since 1997. “Overall, UFE is a safe procedure for treating symptomatic fibroids with minimal risk, while preserving the uterus. There is a five to 10 percent risk of developing premature menopause as a result of uterine artery embolization; however, this has been seen primarily in women over 45 years of age.”

In the past, most women with symptomatic fibroids have been treated surgically. In the United States, 150,000 hysterectomies are performed annually for the treatment of uterine fibroids, according to Dr. Adler.

Within six months after treatment with UFE, patients typically experience a 50 to 60 percent reduction in fibroid size. Heavy menstrual bleeding is controlled almost immediately, Dr. Adler says.

UFE is performed under mild conscious sedation. The interventional radiologist inserts a catheter into the femoral artery and, using fluoroscopic guidance, injects an embolic material that blocks the blood supply to the fibroids, causing them to shrink.

The procedure usually takes about one hour, with x-ray exposure usually averaging about 15 minutes. Most patients will experience significant cramping after the procedure, so patients are kept in the hospital for the night for pain control. By morning, most of the cramps will have subsided and the patient can be released. Patients can expect mild cramping for seven to 10 days after the procedure, Dr. Adler says.

One caveat: women of childbearing age who anticipate becoming pregnant should be aware that there have been no long-term studies to evaluate the incidence of pregnancy following UFE and the effect of this procedure on uterine function.

“There have been several normal pregnancies in our series of UFE patients,” says Dr. Adler. “However, at this point UFE is not recommended for those patients interested in becoming pregnant until more information has been acquired about the affects of UFE on fertility.”

More information about uterine fibroid embolization can be obtained by contacting Louis Adler, M.D., at the Department of Radiology of Saint John’s Health Center at 310-829-8814.

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