Uterine Fibroids (Leiomyomas)
Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren’t associated with an increased risk of uterine cancer and almost never develop into cancer.
What are uterine fibroids
Uterine fibroids are benign tumors that form in or around the uterus, and are typically confirmed with an ultrasound. These growths are quite common, and between 20 and 70 percent of all women will develop them at some point during their reproductive years. While these growths are almost always non-cancerous, they can result in several negative health complications. It’s important to understand the four different types of uterine fibroids, and to watch carefully for the associated symptoms.
Intramural fibroids are the most common type and develop in between the muscular layers of the uterine wall. They can be classified as anterior (front), posterior (back), or fundal (upper), depending on which part of the uterus they are located.
Submucosal fibroids are the least common type of uterine fibroid, and grow in the middle muscular layer of the uterus called the myometrium and encroach on the inner layer of the uterus, the endometrium. Submucosal fibroids have been known to cause menstrual bleeding complications.
Subserosal fibroids develop in the myometrium encroaching on the outside uterine membrane. These can continue to grow outward from the uterus, pushing out into the pelvis.
When submucosal or subserosal fibroids develop on stem or stalk, they are called pedunculated fibroids. These fibroids connect to the tip of these stalk, and can grow both outside and inside the cavity of the uterus
How are uterine fibroids evaluated?
Your doctor may have already diagnosed fibroids by physical exam usually followed by an ultrasound. Up to date PAP smear and an endometrial biopsy are also necessary to make sure there is no sign of cancer prior to considering UFE. Your doctor may also request an MRI of the pelvis to best characterize the type, number and size of your fibroids to provide with the best information on what to expect following treatment.
What are the symptoms associated with uterine fibroids?
Every patient is different, and there is a possibility that uterine fibroids may produce no noticeable symptoms at all. But asymptomatic fibroids can continue to develop over the course of a woman’s reproductive lifetime and become symptomatic later on.
Symptoms may include excessive menstrual bleeding and what is termed bulk symptoms. The sheer size and position of the fibroids cause pressure on the uterus and surrounding organs. Bulk symptoms can include any of the following:
- Chronic pelvic pain
- Very heavy or menstrual cycle irregularity
- Pain during menstruation
- Bladder pressure and frequent urination
- Difficulty emptying the bladder
- Pelvic bloating
- Painful sex
- Constipation
How are uterine fibroids treated?
Uterine fibroid embolization (UFE), also called uterine artery embolization (UAE), is a highly efficacious and minimally invasive procedure that blocks blood flow to the fibroids, ceasing their growth and causing them to shrink over time. UFE has been performed safely in the United States since the 1990s.
A UFE procedure is performed by a highly trained Vascular Interventional Radiologist, done with local anesthestic and under conscious sedation. While the patient is sedated and will not experience pain, they are allowed to remain conscious. A very tiny nick is made in the skin near the femoral artery in the groin or the radial artery in the wrist and a catheter is carefully guided to the pelvic arteries. An angiogram is performed injecting xray contrast to visualize the uterine arteries which are typically very enlarged. There are two uterine arteries, one on each side of the pelvis.
An effective alternative to hysterectomy and myomectomy.
When compared with hysterectomy, UFE is associated with fewer major complications, shorter hospital stays, and faster recovery.
What is Uterine fibroid embolization?
Uterine fibroid embolization (UFE) is a minimally-invasive image-guided procedure that is used to treat uterine fibroids. The procedure involves the injection of micro sized beads into the arteries that feed the fibroids. When injected, the beads block blood flow to the fibroids, causing the fibroids to shrink.
In medicine, the term embolization generally means to block or obstruct a blood vessel.