LJR was one of the first Interventional Radiology services in San Diego to offer this therapy and is one of the most experienced. Our treatment plan is founded upon a close working relationship with experienced gynecologists and includes the personalized care of a staff radiologist and clinical coordinator. Our staff is very experienced in the UFE procedure and we tailor both care and follow-up to the needs of each patient.
Treating Fibroids without Surgery – Alternatives to Hysterectomy
Overview:
- 20-40% of women 35 and older have fibroids of significant size
- Most frequent indication for hysterectomy in pre-menopausal women
- 600,000 hysterectomies performed annually in US; 1/3rd due to fibroids
- Most common tumor of the female genital tract
- Prevalence in female population of childbearing age: 30% or higher
- 10-20% of women with fibroids require therapy
Diagnosis
- Suspected on pelvic examination
- Confirmed with imaging (Ultrasound, MRI)
History
- Embolization first performed 30 years ago
- 1990's French gynecologist first requested uterine fibroid Embolization (UFE) prior to hysterectomy
- Introduced into the USA in 1995 by Drs. McLucas and Goodwin
- As of 2005, 50,000 UFE procedures performed worldwide
The Fertility Issue
- It is unclear how fertility is affected
- Multiple reports of successful pregnancies post embolization
- Large multi-center trial needed
- Myomectomy recommended for those wanting to preserve fertility
Child-bearing Age: Exceptions
- Poor candidate for myomectomy: fibroids are too large and/or numerous
- Failed myomectomy: symptoms reoccur or persist despite myomectomy
- Poor surgical candidate
Results
- Technical success: 98%
- >87% effective in reducing bleeding
- >93% effective in alleviating pain associated with fibroids
- Expected decrease in fibroid volume is 50%
- Patient satisfaction post UFE is 94%
- 73% of women continue to have improvement in symptoms after 5 years. This duration of symptom control is equal to or better than that of myomectomy
Just the Facts……
- Fibroid reoccurrence is exceedingly rare
- UFE is not harmful to the uterus
- In the setting of multiple fibroids, all are treated
Pre-embolization Evaluation
- Gynecology evaluation.
- Routine pre-angiography blood work
- Pelvic MRI or ultrasound for baseline sizing and localization of lesions
- Yearly pap smear
- Endometrial biopsy if bleeding is the primary problem
How Does It Work?
- Two uterine arteries supply the uterus
- Tiny microspheres decrease blood flow to these hypervascular tumors
- Starvation of fibroids results in shrinkage
- UFE Procedure
- Procedure time: 1.5 hrs
- Patient asleep throughout entire procedure
- Normal activity in 5-7 days
- Procedure performed in radiology suite
- Patient comfort is a high priority
- Overnight observation for pain control.
- Discharged to home the following morning
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Post-Procedure Management
Routine overnight admission for pain control
Discharge after 24 hours
Expected Clinical Course
Pelvic pain and discomfort which should progressively decrease and resolve over 2 weeks
Fibroid size decreases over several months time
Uterine Cramping
All will experience a certain degree of uterine cramping following embolization.
Low grade cramping for up to 2 weeks; "roller-coaster" like.
Cost
Equivalent to cost of hysterectomy or open myomectomy
Covered by most insurances
Conclusion
Uterine artery embolization is safe and effective for alleviating symptoms from fibroid disease
>87% success at decreasing or resolving heavy bleeding or pressure symptoms
>93% effective in reducing pain
94% patient satisfaction
Effect on future fertility has not been thoroughly studied
For questions, please contact our Clinical Coordinator Lynette Furnald, R.N.
Pager: (760) 414-4690
 Print LJR Patient Brochure
Print Ask4Ufe Patient Brochure here Find more information at:
Ask 4 UFE
National Uterine Fibroids Foundation
Society of Interventional Radiology
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