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Conditions & Treatments |
Uterine FibroidsConditionWhat are uterine fibroids? Fibroids are the most common tumor of the female genitourinary tract. Fibroids are benign tumors of the uterine muscle, which form when the muscle cells depart from their normal alignment and begin to grow as circular masses. The medical term for fibroid is leiomyoma. Studies suggest that fibroids are very common and are probably present to some degree in the majority of women. The exact causes of fibroid are not well understood, although estrogen, progesterone, and growth hormone appear to promote fibroid growth.What are symptoms of uterine fibroids? Small fibroids rarely cause any symptoms at all unless they are very numerous. However, when fibroids become large in size, they can press upon nearby structures such as the bladder or bowel and cause pelvic pain, pressure, or urinary symptoms including frequent need to void, urgency, and even obstruction of the kidneys. Submucosal fibroids growing near the uterine lining may cause heavy menstrual bleeding. Uncommonly, fibroids may impair fertility or complicate pregnancy by obstructing the fallopian tubes, occupying too much space in the uterus, or by diverting blood flow away from the placenta. In addition to physical symptoms, large fibroids can make a woman appear pregnant when she is not, a situation which may be psychologically distressing. TreatmentWhat type of treatment is available for uterine fibroids?Uterine Fibroid Embolization (UFE), also known as Uterine Artery Embolization (UAE), is a minimally invasive procedure that treats fibroids by blocking their blood supply, causing them to shrink. UFE is an alternative treatment to other available courses, such as hormonal therapy or surgical options. When should I consider uterine fibroid embolization? Fibroids which are not causing significant symptoms and are smaller in size than a twelve week gestation uterus do not need to be removed and may be followed clinically. Fibroids which cause symptoms such as pain, pressure, bleeding or impaired fertility should be considered for treatment. What should I expect BEFORE uterine fibroid embolization? Imaging of the uterus by magnetic resonance imaging (MRI) or ultrasound will be performed prior to the procedure to ensure that fibroid tumors are the cause of symptoms and to fully assess the size, number and location of the fibroids.  Occasionally, your gynecologist may want to take a direct look at the uterus by performing a laparoscopy. If bleeding is a major symptom, a biopsy of the endometrium, the inner lining of the uterus, may be performed to rule out cancer.You should report to your doctor all medications that you are taking, including herbal supplements, and if you have any allergies, especially to anesthesia or to contrast materials (also known as "dye" or "x-ray dye"). Your physician may advise you to stop taking aspirin or a blood thinner for a specified period of time days before your procedure. Also inform your doctor about recent illnesses or other medical conditions. Women should always inform their physician if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy because radiation can be harmful to the fetus. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby. You may be instructed not to eat or drink anything after midnight before your procedure. Your doctor will tell you which medications you may take in the morning. You will be given a gown to wear during the procedure. What should I expect DURING uterine fibroid embolization? The uterus gets its blood supply mainly from the uterine arteries, which are a pair of blood vessels running up the sides of the uterus. Fibroids derive almost all their blood supply from branches of the uterine arteries. When the uterus contains large fibroids, the uterine arteries enlarge significantly in response to the increased blood flow. The process of blocking the uterine arteries with small particles is known as embolization. These particles are made of inert materials and do not react in the body. In order to safely deliver the particles to the uterine arteries, the physician first makes a small incision in the artery near the groin under local anesthesia and inserts a small tube called a catheter. The catheter is then threaded under x-ray guidance into the pelvic vessels and x-ray dye is injected to help locate the uterine arteries. This step is called an angiogram. The catheter is then threaded into one uterine artery and embolization particles are injected into the artery until blood flow slows to a stop. The catheter is then repositioned into the other uterine artery and the process is repeated. When the embolization is complete on both sides, the catheter is removed and pressure is applied to the incision until all bleeding stops. The patient must then remain at bed rest for 6 hours to allow the puncture site to heal sufficiently. What should I expect AFTER uterine fibroid embolization? All women who undergo uterine fibroid embolization will experience varying degrees of pelvic pain and discomfort. This discomfort is related to the fact that the fibroid tissue is deprived of blood flow and oxygen and is dying. The discomfort is most severe in the first 24 hours, and gradually resolves over the following one to two weeks. During this time, some women may also experience mild to moderate fatigue. At Massachusetts General Hospital, all women undergoing the procedure are admitted to the hospital overnight to insure that they receive adequate pain control and are comfortable following the procedure. Patients are discharged home with prescriptions for both narcotic pain medication to be used as needed and ibuprofen to help control uterine cramping. The Nurse Practitioner assigned to you will follow up with frequent telephone calls and keep in close contact with you. The fibroids will shrink on average approximately 40-45% over the first six months. This reduction may be greater in some patients and less in others. Bleeding symptoms usually resolve immediately after the procedure. Our ServiceThe Division of Cardiovascular Imaging & Intervention at Massachusetts General Hospital consists of seven full-time vascular interventional radiologists all of whom are board-certified in general radiology and fellowship trained with additional specialization in vascular and nonvascular interventional procedures. In addition, each has extensive training in the use of x-ray equipment, x-ray dye, and image interpretation.Uterine fibroid embolization is performed by a vascular interventional radiologist specialty trained in performing procedures that require manipulation of catheters inside the blood vessels as well as inside various other parts of the body under x-ray guidance. Please see below for our vascular interventional radiologists who specialize in uterine fibroid embolization: Where is uterine fibroid embolization performed? Massachusetts General Hospital Division of Cardiovascular Imaging & Intervention 55 Fruit Street, Gray 2 (Gray 2 Floor Map  )Boston, MA 02114 How to schedule uterine fibroid embolization A referral from a physician is necessary to make an appointment.
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Contact Us
Massachusetts General Hospital Division of Cardiovascular Imaging & Intervention 55 Fruit Street, Gray 2 Boston, MA 02114 Phone: 617-726-8314 Fax: 617-726-8476  Brochure - Patient Guide to Uterine Fibroid Embolization |
