Uterine Fibroid Embolization

Uterine fibroids are benign tumors that are made up of muscle and connective tissue from the wall of the uterus or womb. They may grow as a single nodule or can be found in clusters that range in size from 1 mm to more than 20 cms (8 inches) in diameter.

There are 3 primary types of uterine fibroids:

Subserosal fibroids: these grow in the outer portion of the uterus and expand outward.

Intramural fibroids: these grow with the wall of the uterus and expand making the uterus feel larger than normal. These are the most common fibroids.

Submucosal fibroids: are deep within the uterus just under the lining of the uterine cavity. These are the least common but very often cause symptoms.

Uterine fibroids may also be referred to by other names such as myoma, leiomyoma, leiomyomata and fibromyoma.

The causes of fibroids are unknown. Most fibroids develop in women of reproductive age and according to most research they occur in black females 2-3 times more frequently than in white females. Rarely are they found in young women who have not begun to menstruate and most often they stabilize or go away after menopause.

Research suggests that obese women are more at risk for uterine fibroids (20% over ideal body weight).

Fibroids are often discovered during routine gynecological examinations or during prenatal care. Most females that develop fibroids are asymptomatic. No treatment is required other than regular observation by their physician. Symptomatic patients may experience the following:

• Excessive or painful bleeding during menstruation
• Low back pain
• Pain during intercourse
• A feeling of fullness in the lower abdomen
• Bleeding between periods
• Pain in the back of the legs
• Bladder pressure leading to a constant urge to urinate
• Pressure on the bowel, leading to constipation and bloating

Verification of fibroids is most often confirmed by abdominal ultrasound. MRI and CT may also be utilized.

Myomectomy is a surgical procedure that removes visible fibroid(s) from the uterine wall. It can be performed several ways: hysteroscopically, laproscopically or abdominally.

Until recently a female with growing uterine fibroids was considered a candidate for a hysterectomy. This creates issues for women in child-bearing ages that would still like to have children. The physical and psychological side effects have to be considered as well. Today many women and their physicians are looking at other treatment options that are based on the individual's symptoms and not solely on the idea that the uterine fibroid(s) will continue to grow until it becomes necessary for a hysterectomy.

The latest treatment that is being utilized is UFE. A small incision is made in the groin and a small catheter is placed through the artery. When the catheter reaches the uterine artery, the interventional radiologist slowly releases tiny plastic particles into the vessels. The particles flow to the fibroids first and wedge into the vessels and can't travel to other parts of the body. This treatment decreases the blood supply to the fibroid(s), which causes them to shrink.

Uterine Fibroid Embolization procedures are performed at both CHRISTUS St. Francis Cabrini Hospital and Rapides Regional Medical Center by Drs. Stephen Rice and Stuart Head.

Additional information is available on request.

ICD-9 DIAGNOSIS CODES:

• Painful menstruation—625.3
• Low back pain—724.2
• Painful intercourse—625.0
• Other symptoms involving the abdomen and pelvis—789.9
• Irregular menstrual cycle—626.4
• Pain in limb—729.5
• Constipation—564.0
• Bloating—787.3