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South
Florida Fibroid Center |
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What are
the benefits vs. risks?
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Benefits
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Minimally invasive: Uterine fibroid embolization (UFE) is
less invasive than either open surgery to remove fibroid
tumors or surgically removing the uterus itself. Patients
ordinarily can resume their usual activities weeks earlier
than if they had a hysterectomy. Blood loss during uterine
fibroid embolization is minimal, the recovery time is much
shorter than for hysterectomy, and general anesthesia is
not required. |
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Relief
of symptoms: Follow-up studies have shown that approximately
85 percent of women who have their fibroids treated by uterine
fibroid embolization experience either significant reduction
or complete resolution of their fibroid-related symptoms.
This is true for women with heavy bleeding and for those
with bulk-related symptoms such as pelvic pain or pressure.
Overall, fibroids will shrink to half their original size
six months after uterine fibroid embolization. |
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Durable effect: Follow-up studies lasting several years
have shown that it is rare for treated fibroids to regrow
or for new fibroids to develop after uterine fibroid embolization.
This is because all fibroids present in the uterus, even
small early-stage masses that may be too small to see on
imaging studies, are treated during the procedure. UFE is
a more permanent solution than another option, hormone therapy,
because when hormonal treatment is stopped the fibroid tumors
usually grow back. Regrowth also has been a problem with
laser treatment of uterine fibroids. |
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Risks
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Catheter-related risks: Any procedure that involves placement
of a catheter inside a blood vessel, including uterine fibroid
embolization, carries certain risks. These risks include
damage to the blood vessel, bruising or bleeding at the
puncture site, and infection. When performed by an experienced
interventional radiologist, the chance of any of these events
occurring during uterine fibroid embolization is less than
1 percent. |
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Allergy to x-ray contrast material: An occasional patient
may have an allergic reaction to the x-ray contrast material
used during uterine fibroid embolization. These episodes
range from mild itching to severe reactions that can affect
a woman's breathing or blood pressure. Women undergoing
uterine fibroid embolization are carefully monitored by
a physician and a nurse during the procedure, so that any
allergic reactions can be detected immediately and reversed.
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Passage of fibroid tissue: From 2 percent to 3 percent of
women may pass small pieces of fibroid tissue after uterine
fibroid embolization. This occurs when fibroid tissue located
near the lining of the uterus dies and partially detaches.
Women with this problem may require a procedure called D
& C (dilatation and curettage) to be certain that
all the material is removed so that bleeding and infection
will not develop. |
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Early onset menopause: In the majority of women undergoing
uterine fibroid embolization, normal menstrual cycles resume
after the procedure. However, in approximately 1 percent
to 5 percent of women, menopause occurs shortly after uterine
fibroid embolization. This appears to occur more commonly
in women who are older than 45 years when they have the
procedure. |
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Need for hysterectomy: Although
the goal of uterine fibroid embolization is to cure fibroid-related
symptoms without surgery, some women may eventually need
to have a hysterectomy because of infection or persistent
symptoms. The likelihood of requiring hysterectomy after
uterine fibroid embolization is low—less than 1 percent.
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Other
UFE Facts
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An estimated 13,000-14,000 UFE procedures are performed
annually in the U.S. (as of 2004). |
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The embolic particles are approved by the FDA specifically
for UFE, based on comparative trials showing similar efficacy
with less serious complications compared to hysterectomy
and myomectomy (the surgical removal of fibroids). |
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Embolization of the uterine arteries is not new. While embolization
to treat uterine fibroids has been performed since 1995,
it has been used successfully by interventional radiologists
for more than 20 years to treat heavy bleeding after childbirth.
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Embolization of fibroids was first used as an adjunct to
help decrease blood loss during myomectomy. To the surprise
of the initial users of this method, many patients had spontaneous
resolution of their symptoms after only the embolization
and no longer needed the surgery. |
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UFE is covered by most major insurance companies and is
widely available across the country. |
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Most women with symptomatic fibroids are candidates for
UFE and should obtain a consult with an interventional radiologist
to determine whether UFE is a treatment option for them.
An ultrasound or MRI diagnostic test will help the interventional
radiologist to determine if the woman is a candidate for
this treatment. |
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Many
women wonder about the safety of leaving particles in the
body. The embolic particles most commonly used in UFE have
been available with FDA approval for use in people for more
than 20 years. During that time, they have been used in
thousands of patients without long-term complications. |
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