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Uterine Fibroids: Treatment of Fibroid Embolization with Interventional Radiology

  • What is Uterine Fibroid?

    A uterine fibroid is a tumor that originates from the tissue of the uterus and is typically benign. Fibroids are among the most common tumors of the female reproductive organs. One in three women over the age of 35 may have fibroids, and they are usually multiple. Fibroids can vary in size, ranging from 1 to 20 cm, and sometimes dozens of fibroids can be found in a single uterus.

    Fibroids can be known by different names: fibroid, leiomyoma, or fibromyoma. The female hormone estrogen contributes to the growth of fibroids; therefore, they typically grow during the reproductive years and pregnancy, while they tend to shrink after menopause.

  • Characteristics and Symptoms of Uterine Fibroids

    Fibroids can often exist in the uterus without causing any symptoms. However, depending on their size and location, they can lead to serious symptoms in some women. These symptoms may include:

    • Painful Menstrual Periods: Pain and cramps are common symptoms caused by fibroids.

    • Heavy Bleeding: Increased menstrual bleeding can lead to hemorrhaging or bleeding disorders.

    • Frequent Urination: Fibroids can exert pressure on the bladder, leading to frequent urination.

    • Pelvic Pressure: As fibroids expand in the abdomen, they can cause a feeling of pressure.

    • Infertility: In some cases, fibroids can make it difficult to conceive.


  • Fibroid Treatment Methods

    The treatment options for uterine fibroids depend on the severity of symptoms, the size and number of fibroids, and the patient's overall health. Below are some of the treatment options:

    1. Hormonal Treatment

      • Hormonal therapy aims to control the growth of fibroids. This treatment can mimic menopause to help shrink the fibroids. However, once the treatment is discontinued, the fibroids may return to their original size. Long-term use of hormonal treatment can also lead to side effects like bone loss.

    2. Myomectomy

      • Myomectomy is a surgical procedure to remove fibroids from the uterus. The surgery is typically performed under general anesthesia, often via an open abdominal incision, though laparoscopic methods may also be available. Myomectomy is usually preferred for young women who want to preserve their fertility. However, in cases where there are many fibroids, it may be difficult to remove all of them, and recurrence is possible.

    3. Hysterectomy

      • A hysterectomy involves the complete surgical removal of the uterus. This method is typically recommended for women who have numerous fibroids, are postmenopausal, or do not wish to have children. The procedure is performed under general anesthesia, and if the ovaries are removed as well, early menopause may occur.

    4. Uterine Artery Embolization (UAE)

      • UAE is a minimally invasive procedure used to treat uterine fibroids. It works by blocking the blood supply to the fibroids, leading to their shrinkage. Here is a detailed overview of the UAE procedure:

      • How It Is Done:

        • Preparation and Anesthesia: UAE is typically performed under local anesthesia, though sedation or general anesthesia may be used in some cases.

        • Catheter Insertion: The procedure is performed by inserting a small catheter through a vein in the groin or arm. The radiologist uses fluoroscopy (X-ray) to guide the catheter to the fibroid’s blood vessels.

        • Embolization: The catheter is used to inject embolizing materials, typically microscopic particles, into the blood vessels feeding the fibroids. This blocks the blood flow to the fibroids, causing them to shrink.

        • Withdrawal and Monitoring: After the procedure, the catheter is removed, and the site is bandaged. Patients are typically monitored in the hospital for a short period.

    UAE is considered a less invasive option compared to surgery and is generally recommended for women who wish to avoid the risks of more invasive surgeries like hysterectomy or myomectomy.

  • Advantages

    1. Minimally Invasive: Compared to traditional surgeries, UAE is less invasive.

    2. Short Hospital Stay: Most patients can be discharged the same day or after spending just one night in the hospital.

    3. Quick Recovery: Patients generally return to their daily activities faster.

    Risks and Disadvantages

    1. Need for Additional Treatment: Some patients may require additional embolization or surgery within 1-2 years after UAE.

    2. Pain and Discomfort: Some patients may experience pain and discomfort after the procedure.

    3. Menstrual Irregularities: There may be changes in menstrual cycles or prolonged bleeding.

    Who Is It Suitable For?

    UAE is preferred for patients who have the following conditions:

    • Patients for whom surgery is risky but still require treatment.

    • Patients who do not wish to undergo surgery.

    • Patients who need a hysterectomy but want to preserve their uterus.

    • Patients who have had previous myomectomy but experience recurrent fibroids.

    Conclusion

    Uterine fibroids are significant benign tumors that affect women's reproductive health and require treatment. Various treatment methods for fibroids vary based on each patient’s condition. Uterine artery embolization offers a minimally invasive option that is an effective alternative to surgery. However, like any treatment, the correct patient selection and guidance from a specialist are critical.

    For more information about uterine fibroids and treatment options, it is essential to consult gynecologists and interventional radiologists.

    This information is supported by verified medical knowledge from Dr. İbadat Hasanov and aims to educate individuals. The treatment plan will be personalized for each individual and carefully evaluated by your healthcare providers.

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