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August 2006 Issue

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Surgery May Not Be Best Option for Uterine Fibroids

By Amanda Harper
Published August 2006

Women who suffer from painful, heavy menstrual cycles due to uterine fibroids have a new, noninvasive treatment option that allows them to avoid the operating room completely.

UC interventional radiologists say the procedure, known as uterine artery embolization, is a safe and effective alternative to surgery for certain women who have uterine fibroids.

“Embolization is most appropriate for premenopausal women facing fibroid complications that affect their quality of life and who don’t want to become pregnant again,” says Darryl Zuckerman, MD, an associate professor and interventional radiologist at UC.

Uterine fibroids are benign tumors that form in the muscular wall of the uterus. Fibroids vary in size—from as small as a golf ball to as large as a cantaloupe—but when left untreated nearly all result in abnormally heavy menstrual bleeding and pelvic pain.

Depending on their size and the severity of symptoms, the growths are traditionally treated by a gynecological surgeon, who removes the uterus or just the visible fibroids.

The new noninvasive uterine artery embolization technique, however, doesn’t require open surgery and can be performed by a specially trained interventional radiologist.

“The problem with conventional surgery is that some women experience additional health complications,” explains Zuckerman. “Uterine artery embolization, on the other hand, yields nearly the same success rates as hysterectomy, but with the benefit of a faster recovery and no major incisions into the body.”

According to the Society of Interventional Radiology, up to 40 percent of American women over 35 have uterine fibroids that require some type of medical intervention.

In addition, one-third of the 600,000 hysterectomies performed each year are due to fibroids.

“Clinical research has shownthat up to two-thirds of hysterectomies done in the United States could have been avoided,” says Zuckerman. “Not all fibroids require treatment, but of those that do, not all can be treated with this minimally invasive technique.”

Prior to undergoing uterine artery embolization, the patient is given a mild anesthetic so she is drowsy but still conscious during treatment. The interventional radiologist then makes a tiny nick (2 mm) in the groin to gain access to the femoral artery. Using moving X-ray images as a visual guide, the physician inserts a catheter and guides it into the uterine artery, which supplies blood to the fibroid.

Minuscule plastic particles—no larger than a grain of sand—are then injected via the catheter into the uterine artery, where they block and cut off the fibroid’s blood supply, causing it to shrink and eventually die.

The procedure takes about an hour, and the patient usually goes home the next day.

“About 90 percent of the women who choose this procedure experience a significant—if not total— relief from heavy bleeding, and about 85 percent have no more pain,” says Zuckerman.

UC radiologists perform about 30 uterine artery embolization procedures each year at University Hospital. For more information or to schedule an appointment, call (513) 584-0792.

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