Medical Information
What are uterine fibroids?
Uterine fibroids are
noncancerous growths in the
uterus. Fibroids can grow on the
inside of the uterus 
,
within the muscle wall of the uterus , or on the
outer surface of the uterus . Fibroids can change the shape of the uterus as
they grow. This can cause pregnancy problems. Over time, the size, shape,
location, and symptoms of fibroids may change.
The cause of
uterine fibroids is not known. But after fibroids develop, the hormones
estrogen and
progesterone appear to influence their growth. A
woman's body produces the highest levels of these hormones during her
childbearing years. After menopause, when hormone levels decline, fibroids
often shrink or disappear.
Fibroids are also called myomas,
leiomyomas, and fibromas.
What are the symptoms of uterine fibroids?
As
women age, they are more likely to have uterine fibroids, especially from their
30s and 40s until menopause. About 80% of women have uterine fibroids by the
time they reach age 50. Most have mild or no symptoms.2 But fibroids can cause serious problems that need treatment.
Uterine fibroids usually need treatment when they cause:
- Anemia from
heavy fibroid bleeding.
- Ongoing low back pain or a feeling of
pressure in the lower abdomen (pelvic pressure).
- Blockage of the urinary tract or bowels.
Fibroid problems that need treatment-but not with uterine
fibroid embolization-include:
- Infertility
caused by fibroids that change the shape of the uterus or the location of the
fallopian tubes.
- Complications during
pregnancy, such as
miscarriage or premature labor.
- Infection,
if the tissue of a large fibroid dies.
What is uterine fibroid embolization?
Uterine
fibroid embolization (UFE) is a nonsurgical procedure that blocks blood flow to
fibroids in the uterus. Fibroids treated with UFE shrink by half or more.
Normal uterine tissue usually remains unharmed, because it is supplied by other
arteries.3
During UFE, a thin, flexible
tube called a catheter is threaded into a blood vessel in the upper thigh
(femoral artery). A substance called contrast material is then injected into
the catheter. The radiologist uses real-time X-ray on a video screen (fluoroscopy) to see the arteries and guides the
catheter to the arteries that supply blood to the fibroid. A solution of
polyvinyl alcohol (PVA) particles is injected into those uterine arteries
through the catheter. These particles build up in the targeted arteries and
block blood flow.
UFE is a fibroid treatment for women who have
no childbearing plans. This is because some women have developed ovary damage,
early menopause, or infertility after UFE.4 This
procedure must be performed by a highly experienced interventional radiologist,
because it carries risks of serious complications.
When is uterine fibroid embolization an option for the treatment of uterine fibroids?
Uterine fibroid embolization is used to
control heavy, prolonged menstrual bleeding when:
- Bleeding has not responded to other
treatments.
- You have no future childbearing plans.
- You
prefer not to have a
hysterectomy to control bleeding. (On rare occasions,
emergency hysterectomy is needed to treat UFE complications.)
- Other
medical problems, such as severe lung or liver disease, make it dangerous for
you to have
general anesthesia for a hysterectomy.
How effective is uterine fibroid embolization for the treatment of uterine fibroids?
UFE is usually an effective treatment. But
in one study, about 1 in 5 women who had UFE needed another UFE or a
hysterectomy within the next 3½ years.1
Shorter-term studies have reported that:3
- About 85% of women treated with UFE have said that their
fibroid-related symptoms improved.
- Uterine fibroid embolization
shrinks fibroids an average of 48% to 78%.
- After 6 years, uterine
fibroids return in 10% to 27% of women treated with UFE.
Although there are reports of pregnancy after uterine
fibroid embolization, experts do not yet fully know the risks to pregnancy.
There appear to be more pregnancy complications than normal after UFE.4
What are the benefits of uterine fibroid embolization
Uterine fibroid embolization (UFE) may be an option for women who want to
avoid the risks of surgery. It is done with local anesthesia, and the doctor
does not have to make any incisions or cuts in the skin. For most women, UFE
means a shorter hospital stay, compared to a hysterectomy, and a quicker return
to normal activities.5
What are the risks of uterine fibroid embolization?
The risk of complications after uterine fibroid embolization is low but
includes:6
- Infection. This is the most serious,
potentially life-threatening complication of UFE. See your doctor immediately
if you have a high fever and feel ill or notice pus in your vaginal discharge.
In rare cases, emergency hysterectomy is needed to treat an infected uterus.
- Loss of menstrual periods (amenorrhea).
- Premature
menopause.
- Scar tissue formation (adhesions).
For more information, see the topic
Uterine Fibroids.
Wise Health Decision
Use this worksheet to help you make your decision.
After completing it, you should have a better idea of how you feel about having
uterine fibroid embolization to treat uterine fibroids. Discuss the worksheet
with your doctor.
Circle the answer that best applies to
you.
| I have severe symptoms of uterine fibroids. | Yes | No | Unsure |
| My symptoms are gradually getting worse. | Yes | No | Unsure |
| My menstrual bleeding is severe or lasts longer
than 7 to 10 days. | Yes | No | Unsure |
| I have been told that I have anemia caused by
heavy menstrual periods. | Yes | No | Unsure |
| I wish to become pregnant. | Yes | No | Unsure |
| I am approaching menopause. | Yes | No | Unsure |
| Treatment with prescription medicines, such as
leuprolide (for example, Lupron), has failed to relieve my symptoms. | Yes | No | NA* |
| I have other medical conditions (such as kidney
failure, liver failure, or a bleeding disorder) that would make other
treatments risky. | Yes | No | NA |
| I have had a blood clot in my legs or lungs. | Yes | No | NA |
*NA = Not applicable
Use the following space to list any other important concerns you have
about this decision.
What is your overall impression?
Your answers in
the above worksheet are meant to give you a general idea of where you stand on
this decision. You may have one overriding reason to have or not have uterine
fibroid embolization.
Check the box below that represents your
overall impression about your decision.
Leaning toward having uterine fibroid embolization | | Leaning toward NOT having uterine fibroid embolization |
Return to the topic
Uterine Fibroids.
