Uterine Fibroid Embolization

Vascular interventional radiologists, Phillip Zeni, Jr., M.D., Rich Duszak, Jr., M.D., F.A.C.R., F.S.I.R, and David Peeler, M.D. are now performing uterine fibroid embolization, a procedure to treat fibroid tumors, at Baptist Memorial Hospitals - Memphis and DeSoto through the Memphis Interventional Radiology Clinic.

Uterine fibroid embolization is a new treatment procedure that blocks the arteries supplying blood to fibroid tumors. It is the latest treatment option available for women with uterine fibroids, which are noncancerous growths that develop in the muscular wall of the uterus. Fibroid tumors of the uterus are very common, and have been treated, depending on size and location, by a variety of options, including drug therapy, myomectomy, and hysterectomy. Uterine fibroid embolization studies were first reported in the United States in 1997. By the end of 1998, about 1,500 to 2,000 fibroid embolization procedures had been done world-wide.

During uterine fibroid embolization, the interventional radiologist makes a small nick in the skin at the top of the leg to insert a tiny catheter into the femoral artery. The patient is conscious but sedated (drowsy and not feeling any pain). Using x-ray imaging to guide the catheter, the interventional radiologist moves the catheter into the uterine artery, then slowly injects tiny plastic or gelatin sponge particles into the blood vessels feeding the fibroid. These particles become trapped by the fibroid and cannot move to other areas of the body. It takes several minutes to block the artery. Then the procedure is repeated so that both the right and left uterine arteries are blocked. Sometimes both uterine arteries can be blocked from one puncture site, but sometimes it's necessary to puncture the femoral artery at the top of both legs. The procedure itself takes 1 to 2 hours.

Patients usually stay one night in the hospital, but some women go home the same day of the procedure. Patients should expect six to eight hours of bed rest following the procedure, and a prescription of pain-killing medications and drugs that combat swelling. Typical side effects include cramping and fever, with total recovery in one to two weeks. Complications, including injury to the uterus or infection, occur in fewer than three percent of patients.

Once the blood flow to the fibroid is blocked, the tumor shrinks. Studies have shown that fibroids generally reduce 50 percent after three months. While embolization to treat fibroids is relatively new, embolization of arteries in the uterus for other reasons has a successful 20-year history. This procedure has been used for six years to successfully treat fibroids.

The effect of this procedure on fertility has not been documented, but more than a dozen pregnancies have been reported and patients who have had uterine arteries embolized for other reasons have successfully become pregnant.



More information on uterine fibroid embolization and treatment options can be found at www.scvir.org/fibroid/treatments.htm.