Uterine Fibroid Embolization (UFE)

Learn more about Fibroids and your treatment options

• What does the research say about fibroid statistics?

  Studies demonstrate the prevalence of fibroids in 20-40% of women older than 35 years of age,¹ based on imaging and clinical evaluation

  On surgical evaluation, fibroids are seen in nearly 70-80% of patients.

  Evidence suggests that African-American women are three times more likely to develop uterine fibroids^2-4 than other women, with an earlier age of onset.⁵

  Most clinicians believe fibroids shrink when a woman goes through menopause.

   

  REFERENCES:

  1. Wallach EE. Myomectomy. In: Thompson JD, Rock JA, eds. Te Linde’s Operative Gynecology, 7th ed. Philadelphia: J.B. Lippincott, 1992; pp 647-662.
  2. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. Am J Obstet Gynecol. 2003;188:100–107.
  3. Marshall LM, Spiegelman D, Barbieri RL, et al. Variation in the incidence of uterine leiomyoma among premenopausal women by age and race. Obstet Gynecol. 1997;90:967–973.
  4. Wise LA, Palmer JR, Stewart EA, Rosenberg L. Age-specific incidence rates for self-reported uterine leiomyomata in the Black Women’s Health Study. Obstet Gynecol. 2005;105: 563–568.
  5. Huyck KL, Panhuysen CI, Cuenco KT, et al. The impact of race as a risk factor for symptom severity and age at diagnosis of uterine leiomyomata among affected sisters. Am J Obstet Gynecol. 2008;198:168 e161–169.
• How do you diagnose fibroids?

  Many times the patient’s age and symptoms often provide strong clues to the clinical diagnosis of fibroids. Initial evaluation is often pursued with pelvic/transabdominal ultrasound. While this form of imaging is great at looking for fibroids, it can miss certain types and sizes of fibroids and is dependant both on the equipment and the person performing it.

  For the purposes of diagnosis, your interventional radiologist will order an MRI (possibly with the addition of pictures to look at the blood vessels). The advantages of having an MRI versus and ultrasound are akin to looking at something in color under high definition as opposed to in black and white under standard definition.

  In addition, MRIs allow you to evaluate the pelvis not just for fibroids but for other potential causes of symptoms like adenomyosis, endometriosis, varicose pelvic veins causing discomfort (pelvic congestion syndrome) and compression of the leg veins resulting in pelvic/limb discomfort (May-thurner syndrome). They will allow for a consistent comparison of the size and location of your fibroids both before and after treatment. Interventional radiologists have the expertise to interpret these images and evaluate for these other often missed sources of pelvic pain.

• Symptoms of Fibriods

  Excessive Menstrual Bleeding
  Heavy menstrual bleeding is one of the most common symptoms associated with uterine fibroid tumors. It is the most prevalent symptom for two of the four types of uterine fibroid tumors: intramural and submucosal. Over time, excessive menstrual bleeding can lead to fatigue and anemia, which is a result of low red blood cell count. If left untreated, excessive menstrual bleeding can eventually lead to the need for blood transfusions.

  Pelvic Pain and Pressure
  As fibroids grow, they can put additional pressure on the surrounding organs, which can be extremely painful. The growth of the fibroids can cause consistent lower abdominal pain, as well as swelling which is sometimes mistaken for as weight gain or pregnancy. If you are experiencing pelvic pain or pressure or any other type of uterine fibroid symptoms, a full gynecological exam should be done immediately to determine the cause.

  Urinary Incontinence or Frequent Urination
  One of the organs commonly affected during the growth of fibroid tumors is the bladder. As added pressure is applied to this organ, the risk of urinary incontinence (loss of bladder control) occurs, as well as frequent urination.

  Other Symptoms
  Other common symptoms include anemia, pain in the back of the legs, pain during sexual intercourse, constipation, and an enlarged abdomen.

• Types of Fibroids

   

  

  Intramural
  The most common type of fibroids, intramural fibroid tumors, typically develop within the uterine wall and expand from there. When an intramural fibroid tumor expands, it tends to make the uterus feel larger than normal, which can sometimes be mistaken for pregnancy or weight gain. This type of fibroid tumor can also cause “bulk symptoms” which include excessive menstrual bleeding that may cause prolonged menstrual cycles and clot passing, and pelvic pain that is caused by the additional pressure placed on surrounding organs by the growth of the fibroid.

  Subserosal
  Subserosal fibroids typically develop on the outer uterine wall. This type of fibroid tumor can continue to grow outward and increase in size. The growth of a subserosal fibroid tumor will put additional pressure on the surrounding organs, causing pelvic pain and pressure, and tend not to interfere with a women’s typical menstrual flow. Depending on the severity of the location of the fibroids, other complications may accompany pain and pressure such as bloating, indigestion, constipation, and frequent urination.

  Submucosal
  These fibroids develop under the lining of the uterine cavity. Large submucosal fibroid tumors may increase the size of the uterus cavity and can block the fallopian tubes, which can cause complications with fertility. Associated symptoms with submucosal fibroids include very heavy, excessive menstrual bleeding and prolonged menstruation. These symptoms can also cause the passing of clots and frequent soiling accidents. Untreated, prolonged or excessive bleeding can cause more complicated problems such as anemia and/or fatigue, which could potentially lead to a future need for blood transfusions.

  Pedunculated
  This type of uterine fibroid occurs when a fibroid tumor grows on a stalk, resulting in pedunculated submucosal or subserosal fibroids. These fibroids can grow into the uterus and/or outside of the uterine wall. Symptoms associated with pedunculated fibroid tumors include pain and pressure as the fibroid may sometimes twist on the stalk.