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Fibroids: The Latest Treatments

By Heather Maloney
Beth Israel Deaconess Medical Center Correspondent

A minimally-invasive procedure has been shown to successfully treat uterine fibroids while requiring little downtime for the patient and preserving the woman’s uterus.

“This is another treatment option for women to consider,” says Dr. Yvonne Gomez-Carrion, an OB/GYN at Beth Israel Deaconess Medical Center in Boston and an assistant professor of obstetrics and gynecology at Harvard Medical School. “It’s a great option for a woman who is an appropriate candidate and doesn’t want to have surgery.”

Called uterine fibroid embolization (UFE), this non-surgical procedure is performed while the patient is conscious but sedated, and typically requires only an overnight hospital stay. An abdominal hysterectomy, the traditional treatment for fibroids, typically requires a 2-3 day hospital stay and a recovery period of about six weeks. Also, a total hysterectomy removes the entire uterus, while UFE does not.

Fibroids are tumors made up of muscle cells and other tissue that grows within the wall of the uterus. According to the National Institutes of Health, uterine fibroids are the most common non-cancerous tumors in women of childbearing age.

Most fibroids don’t cause any discomfort; only about 10 to 20 percent of women who have fibroids require some form of treatment. Depending on the location, size and number of fibroids, a patient may experience heavy, prolonged menstrual periods and unusual monthly bleeding, pressure on the bladder or bowel, an abnormally enlarged abdomen, pelvic pain, and pain during sexual intercourse.

In UFE, also referred to as uterine artery embolization, the doctor makes a small incision (usually in the groin area) and inserts a thin, flexible tube. Tiny pellets of glycerin are injected through the tube into the arteries that feed the fibroids. The pellets block the vessels supplying blood to the fibroids, cutting off their blood supply and causing them to die.

While this procedure does preserve the uterus, it is not recommended for women who wish to get pregnant. “It’s not advised for women who want to have children,” says Dr. Gomez-Carrion. “It could change the wall of the uterus, which could create an area of weakness that could potentially rupture with a pregnancy.” The medical literature shows that approximately one-third of women who have had UFE and then gone on to become pregnant have had pregnancy issues.

The procedure has other risks as well. “UFE can put you into an earlier menopause, though that can be a positive for some women who have been experiencing extreme symptoms with their fibroids,” says Dr. Gomez-Carrion. And, though small, there is also the risk of infection.

Dr. Gomez-Carrion points out that UFE is not an option for every patient. If you suffer from uterine fibroids, she advises that you discuss all of the options with your doctor.

To contact the Department of Obstetrics and Gynecology at Beth Israel Deaconess Medical Center, call 800-667-5356.

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