Uterine Fibroid Q&A with Dr. Asay
Uterine fibroids are a common cause of pelvic pain, pressure, and heavy menstrual bleeding in women. Approximately 70% of women will develop uterine fibroids by the time they are 50.
Dr. Mark S. Asay sat down for an interview discussing uterine fibroids and uterine artery embolization:
Introduction
Dr. Asay: My name is Mark Asay. I joined the IVC practice in 2005 and I am one of the physicians in vein care at the clinic.
Dr. Mark S. Asay is fellowship-trained and board certified in interventional radiology. His expertise includes treatment of disorders of arterial and venous circulation and acute stroke intervention.
What are uterine fibroids?
Dr. Asay: Uterine fibroids are benign tumors that grow in the muscle of the uterus.
What are the symptoms of uterine fibroids?
Dr. Asay: The symptoms of uterine fibroids are typically related to the location and size of the fibroid. The fibroid can cause excessive and prolonged bleeding with menstruation. They can cause pain, back aches, they can also lead to infertility and problems with urination and bowel movements.
Who do uterine fibroids affect?
Dr. Asay: Uterine fibroids affect women of reproductive age. Uterine fibroids are influenced by progesterone and estrogen.
How are uterine fibroids diagnosed?
Dr. Asay: Uterine fibroids can be diagnosed by physical examination but typically further evaluation with an ultrasound or MRI is required.
How are uterine fibroids treated?
Dr. Asay: Uterine fibroids can be treated in several ways, first they can be treated with medications such as birth control pills or hormone blockers. They can also be treated surgically with a hysterectomy. Occasionally they can also be cut out and the fibroid itself removed. They can also be treated by embolization.
Hormonal methods: Include oral contraceptives, skin patches, vaginal rings, hormonal IUD, and implants. Hormonal therapy helps alleviate heavy bleeding, cramping, and pain.
Hysterectomy: Surgical removal of the uterus.
Myomectomy: Surgical removal of uterine fibroids. There are multiple approaches to perform myomectomy depending on the size and location of the fibroid. Abdominal myomectomy requires an incision in the lower abdomen to remove the fibroids. Laparoscopic myomectomy uses smaller incisions along with thin instruments and a camera (laparoscope) to remove fibroids. Hysteroscopic myomectomy is used for fibroids located inside the uterus.
Uterine artery embolization: Also known as uterine fibroid embolization (UFE). This is a minimally invasive procedure where tiny catheters are advanced into the uterine artery to disrupt the blood flow to the fibroid causing it to shrink.
What are the advantages of uterine artery embolization?
Dr. Asay: Well, the advantages of uterine artery embolization are that fertility is preserved as opposed to a hysterectomy. No surgery is involved so there is typically less pain and much quicker recovery than the 6 weeks typically required after a hysterectomy.
How effective is embolization?
Dr. Asay: 90% of women will have significant improvement in symptoms within 2-3 months and symptom relief will continue through 6 months or longer.
How is uterine artery embolization performed?
Dr. Asay: Uterine artery embolization is performed on an x-ray table. A needle is placed into the artery in the groin and a small catheter about the size of a spaghetti noodle is introduced and placed into each of the uterine arteries. Embolic particles are slowly injected until the blood flow to the fibroids is eliminated.
Does embolization affect fertility?
Dr. Asay: Embolization can improve fertility if the fibroids are causing a problem with fertility. In a patient where there has been no fertility problems, its not well studied, but many women have gotten pregnant and carried pregnancies to term after a uterine artery embolization.
Is embolization painful?
Dr. Asay: Shortly after the procedure there can be significant pain and cramping which is typically well treated with pain medications. Women can also experience flu like symptoms for a few days to a week after the procedure.
What are the restrictions post-treatment?
Dr. Asay: The restrictions are pretty short term, usually we want a patient to avoid heavy lifting or exertion for 1-2 days and exercise for a week.
