Women’s Health

Uterine fibroids

Uterine Fibroids (leiomyoma) is a specific type of benign tumor that occurs in the muscle cells of the uterus. Uterine fibroids can alter a woman’s period in many different ways. Research has shown that that uterine fibroids will affect 70 percent of white women and 80 percent of African American women in the U.S. by the time they are 50 years old. You are at increased risk for developing fibroids if you are overweight, African American, over the age of 40, have high blood pressure, have had no children, and have a family history of fibroids.

Patients with fibroids may experience:

  • Uterine pressure or pain
  • Heavy menstrual bleeding
  • Severe cramps
  • Abdominal enlargement
  • A bloated feeling
  • Pain during or following intercourse
  • Pain down the back of one or both legs
  • Constipation
  • An urge to urinate frequently

To treat the uterine fibroids, an interventional radiologist (IR) can perform a treatment called Uterine Fibroid Embolization, or UFE. This is sometimes referred to as Uterine Artery Embolization or UAE. UFE avoids surgery, preserves your uterus, controls symptoms and improves quality of life. Approximately nine out of 10 women who undergo uterine fibroid embolization will experience significant improvement, or their symptoms will go away completely.

Under X-ray guidance and sedation, the interventional radiologist can access the blood vessel carrying nutrients to the tumor through a small incision in the wrist or groin. The IR then guides a very thin catheter (about the size of a strand of spaghetti) into the incision and through your blood vessels to the specific artery supplying blood to the fibroid.

Once the catheter is in the proper position, the doctor releases small particles at the targeted location to block the small vessels and deprive the fibroid of nutrients shrinking the fibroid When embolization is completed, the catheter is removed.

After undergoing uterine fibroid embolization, you may be admitted overnight in the hospital to manage any pain resulting from the treatment. Typically, you’ll be sent home with oral pain medication to use for an additional few days.

Most women are back to their normal activity in about one week. You’ll follow up with the interventional radiologist and your gynecologist a few weeks later. Some women may experience symptoms of post-embolization syndrome, including pelvic pain and cramping, nausea/vomiting, low-grade fever, fatigue and discomfort. These symptoms may resolve themselves and disappear within 2-7 days.

Pelvic Pain / Pelvic Congestion Syndrome

Chronic pelvic pain that occurs because of pelvic congestion syndrome is often felt below the belly button in the pelvis. A number of conditions can cause chronic pelvic pain, including enlarged varicose veins in the ovaries and pelvis. In the pelvis, veins have one-way valves that help keep blood flowing toward your heart. If the valves are weak or damaged, blood can pool in your veins, which causes them to swell. When this happens near the pelvis, it is called pelvic congestion syndrome. Women with pelvic congestion syndrome often experience pain during or following intercourse.

Pelvic congestion syndrome usually affects women who have previously been pregnant because the ovarian and pelvic veins widened to accommodate the increased blood flow from the uterus during pregnancy. After the pregnancy, some of these veins remain enlarged and fail to return to their previous size, causing them to weaken, and allowing blood to pool.

Pelvic congestion syndrome is treated with ovarian vein embolization by an IR using X-ray guidance and mild sedation. Ovarian vein embolization is a same-day treatment, which takes place in an interventional radiology suite. Through a small incision in your groin or wrist, the IR passes a small catheter through your veins to reach the enlarged pelvic veins responsible for the congestion.

The catheter allows the introduction of embolic agents, medications that seal off the vein, relieving the painful pressure. When the catheter is removed, pressure is applied to the vein. After treatment, women can return to normal activities immediately.