Interventional Radiology - Uterine Artery Embolyzation
Uterine fibroids are benign tumors of muscle cells and fibrous tissue that form inside the uterus. Fibroids may cause no symptoms, while in other women produce heavy vaginal bleeding and “bulk symptoms” (pelvic pain, pressure on the bladder causing a sensation of fullness, lower back pain). Fibroids can also be a cause of pregnancy loss in some women.
Treatment options for uterine fibroids that are causing symptoms include: (1) hormonal therapy (to temporarily shrink the fibroids), (2) surgical removal of one or more fibroids (myomectomy), or (3) removal of the uterus (hysterectomy). More recently, a minimally invasive procedure has become widely available called uterine fibroid embolization. Analogous to thirsty plants that need to be watered daily, survival of fibroid tumors depends on a continuous supply of nourishment from blood vessels. If these blood vessels are blocked, the fibroids will gradually shrink down in size, similar to a plant that withers from a lack of water. Uterine fibroid embolization is a procedure that doctors use to shut down blood supply to the fibroids by injecting tiny sand-like particles into the arteries of the uterus so that shrinkage will occur. In 95% of women who are candidates for uterine artery embolization, their bleeding symptoms are improved. In approximately 70% of women with “bulk symptoms” who are candidates will have improvement.
RIMA interventional radiologists perform uterine fibroid embolization procedures in hospital based interventional radiology suites under “twilight anesthesia” and local anesthetic. Through a tiny nick in the skin, the doctor inserts a soft plastic catheter into an artery near the patient’s hip. Guided by a specialized x-ray camera, the catheter is carefully steered into the arteries of the uterus which nourish the fibroids. At this point, microscopic particles of plastic spheres (which are inert and compatible with body) are injected until the desired amount of blockage is achieved. The catheter is removed and the doctor presses on the patient’s skin where the artery was entered until bleeding stops. After 15 minutes, a Band-Aid is applied to the insertion site. The patient remains in hospital overnight, and can usually return home the following day.