Uterine Fibroid Embolization is a treatment of fibroids that blocks the arteries that supply blood to the fibroids. It is a minimally invasive procedure, which means it requires only a tiny nick in the skin, and is performed while the patient is sedated - and feeling no pain.
Fibroid embolization at Lourdes is done in the hospital by an interventional radiologist, a physician who is specially trained to perform this and other minimally invasive procedures.
What Are Uterine Fibroids?
Uterine fibroids are the most common pelvic tumors in women, occurring in approximately 30% of women over the age of 35. Although fibroids are benign (non-cancerous), they may produce a wide variety of symptoms including excessive bleeding leading to iron deficiency anemia and lethargy, pain and pressure sensations, and even obstruction of the bowel or urinary tract.
The exact causes for fibroid development are unclear, but researchers have linked them to both a genetic predisposition and a subsequent development of susceptibility to hormone stimulation. Women may have a genetic predisposition to fibroid development and then subsequently develop factors that allow fibroids to grow under the influence of a number of hormones. This would explain why certain ethnic groups or racial groups are more likely to develop fibroids and also why there tends to be genetic predisposition in some families.
Fibroids range greatly in size from very tiny (a quarter of an inch) to larger than a cantaloupe (10 inches or more). In some cases they can cause the uterus to grow to the size of a five-month pregnancy and the woman looks as though she is pregnant. In most cases, there is more than one fibroid in the uterus.
The interventional radiologist makes a small nick in the skin (less than one-quarter of an inch) in the crease at the top of the leg to access the femoral artery, and inserts a tiny tube (catheter) into the artery. Local anesthesia is used so the needle puncture is not painful. The interventional radiologist steers the catheter through the artery to the uterus using X-ray imaging (fluoroscopy) to guide the catheter's progress. The catheter is moved into the uterine artery at a point where it divides into the multiple vessels supplying blood to the fibroids. An arteriogram (a series of images taken while radiographic dye is injection) is performed to provide a road map of the blood supply to the uterus and fibroids.
The interventional radiologist slowly injects tiny plastic (polyvinyl alcohol or PVA) or gelatin sponge particles the size of grains of sand into the vessels. The particles flow to the fibroids first, wedge in the vessels and cannot travel to other parts of the body. Over several minutes, the arteries are slowly blocked. The embolization is continued until there is nearly complete blockage of the blood flow in the vessel.
The procedure is then repeated on the other side so the blood supply is blocked in both the right and left uterine arteries. Some physicians block both uterine arteries from a single puncture site, while others puncture the femoral artery at the top of both legs. After the embolization, another arteriogram is performed to confirm the results. The skin puncture where the catheter was inserted is cleaned and covered with a bandage. The procedure takes approximately 1 to 1 1/2 hours.
As a result of the restricted blood flow, the tumor (or tumors) begin to shrink, and symptoms resolve.
Where to go.
For information on where to go when you arrive for your appointment, visit our Where to Go page.
For more information contact Deb or Sue in the Lourdes Radiology Department at 607-798-5225 ext. 2096.
View Uterine Fibroid Embolization images.