If you are a woman who suffers from symptoms related to uterine fibroids, you may be exploring options for treatment. Many women visit their OB/GYN to seek relief from debilitating fibroid-related symptoms and are presented with only surgical options for treatment.
What do you do if you do not want to have surgery for fibroids? What if you want to keep your uterus or not have it compromised? Is there any other way to eliminate fibroids other than surgery? The good news is that yes, there is! There is a treatment that causes fibroids to shrink and fibroid symptoms to resolve, all without surgical intervention.
To better understand how this treatment works when compared with surgical options, we are first going to cover some of the basics.
What are Uterine Fibroids?
Uterine fibroids are non-cancerous growths that form in or on the uterus. Fibroids grow in a variety of sizes and can be very small as the size of a bead or as large as a pumpkin.
Women can have one fibroid or several, and they can grow singularly or in clumps. They can grow in different locations and are classified depending upon where they grow within the uterus.
What Are Symptoms of Uterine Fibroids?
- Lower back or leg pain;
- Pelvic pain and pressure;
- Abdominal bloating or swelling;
- Menstrual pain and cramping;
- Pain during sexual intercourse;
- Frequent urination;
- Heavy menstrual bleeding;
- Prolonged menstrual bleeding;
- Anemia with such signs as fatigue, lightheadedness, headache, craving ice, palpitations, thinning hair.
Where Do Uterine Fibroids Come from?
Unfortunately, experts have not yet identified why uterine fibroids develop in some women, but we do suspect that there is a genetic cause. We also know that fibroids develop when some of the smooth muscle cells that are normally present in the wall of the uterus start growing abnormally in response to natural hormones like estrogen. Based on research and statistical analysis, experts in the field also have information regarding other characteristics and environmental factors that contribute to the growth of fibroids.
Different Classifications of Uterine Fibroids
Fibroids are identified (labeled) by how they grow and where they grow.
How Fibroids Grow
- Sessile fibroids grow directly attached to the uterus.
- Pedunculated fibroids are attached to the uterus with a stalk or stem-like section of tissue.
Where Fibroids Grow
- Outside the uterus – subserosal fibroids can be sessile or pedunculated and grow off the outer surface of the uterus. Normally, subserosal fibroids will not cause heavy menstrual bleeding, but they can be problematic if they grow large enough to compress other nearby organs. This can cause issues with reproduction and bulk symptoms like pelvic pain, bloating, pelvic pressure, and urinary frequency.
- Within the walls of the uterus – intramural fibroids can be embedded inside the muscular walls of the uterus with portions protruding outward. They are the most common type of fibroids and can cause symptoms such as heavy bleeding and infertility.
- Into the uterine cavity – submucosal fibroids account for only 5% of all uterine fibroids that occur but they are the ones most associated with heavy menstrual bleeding and infertility. Because they grow into the uterine cavity, they can deform the inner lining of the uterus and affect a woman’s ability to conceive. They also can cause prolonged, heavy menstrual bleeding that can lead to anemia.
What Surgical Treatment Options Are Typically Offered for Treating Fibroids?
Surgical treatments that are used to eliminate fibroids are performed by OB/GYNs. Unfortunately, some OB/GYNs do not offer or suggest that women first try a less invasive form of treatment. Myomectomy and hysterectomy surgeries are sometimes offered as the first or only treatment options, when they should be the last resort for many women.
Myomectomy is a surgery where fibroids are cut out of the uterus and removed by the surgeon one at a time. This may require a large incision on the lower abdomen for some women. Or, if this is done laparoscopically and the fibroids are large, they must be shredded (or morcellated) into smaller pieces before they can be removed. Depending on where the fibroids are growing, the surgeon may have difficulty removing certain fibroids. For instance, a fibroid that is deeply embedded into the uterine wall may be very hard to cut out. Also, if the fibroids are numerous or small the surgeon will not be able to remove them all.
Different techniques can be used to perform myomectomies but the result is the same.
- The uterus can be left weak and compromised.
- Often several fibroids are left behind and will continue to grow
- The majority of women who undergo a myomectomy experience fibroid regrowth within 5 years and require another surgery.
- Leaving the uterus compromised can impact fertility and if the patient becomes pregnant, they must have a mandatory C-section.
Some women who choose a laparoscopic myomectomy so they can keep their uterus may end up having a different type of surgery than what is originally planned. If the surgeon encounters difficulty, they may have to switch the type of operation in the middle of the surgery and add a large abdominal incision to be able to complete the surgery safely. In some cases, if there is too much bleeding or if the uterus can’t be put back together in the right way, the surgeon may have to urgently do a hysterectomy and remove the uterus to protect the patient from blood loss or death. Before surgery, women have to sign a waiver stating that the surgery can be converted into a hysterectomy if the surgeon finds it necessary.
Hysterectomy is a surgical procedure that involves the permanent removal of the uterus. This can be done laparoscopically or in cases of cancer, as “open” surgery with a larger abdominal incision. The unbelievable truth is that only 10% of the hysterectomies performed each year in the United States are medically necessary.
During a hysterectomy, the entire uterus can be removed, or just a portion of it. This can also be accompanied by one or both ovaries, the cervix, and the fallopian tubes. After a hysterectomy, a woman can’t become pregnant.
Historically it was thought that the uterus was only necessary for growing a baby and that if a woman was done with that part of her life then she no longer needed it. Findings from recent research have proved this to be untrue. The uterus has a connection to mental health, heart health, spatial memory, depression, and anxiety.
Also, the uterus provides a framework of support for other organs such as the bladder and bowels. When the uterus is removed, the structural support is also removed so in addition to the symptoms brought on by early menopause, women who have had a hysterectomy often have side effects including urinary incontinence, pelvic prolapse, bowel issues, etc.
Many younger women are being told they need to have hysterectomies but research shows that a woman’s age plays a role in her risk for heart disease. The younger she is at the time of hysterectomy, the more at risk she will be. We already know that heart disease kills more women each year than anything else, so we do not need to help add to that statistic.
How Can You Get Rid of Fibroids without Surgery?
Now that we have a good understanding of the surgical options and their related side effects, let’s talk about uterine fibroid embolization or UFE as it is often referred to. UFE is a non-surgical, outpatient procedure that eliminates fibroid-related symptoms by taking away their blood supply, stopping them from bleeding, and causing them to shrink.
How Does UFE Work to Shrink Fibroids?
The medical term “embolization” means to stop or block blood flow in a blood vessel or an organ. Fibroids need a blood supply to grow and thrive, so cutting off that blood supply is key in their elimination.
Uterine fibroid embolization is a short 30-45 minute procedure done with the patient under sedation. A tiny catheter which is a soft, flexible, hollow tube is placed into an artery in the leg or wrist, just like an IV would be placed into a vein. The catheter is long and is advanced to the pelvis using image guidance. The tip of the catheter is placed in the arteries that supply blood to the fibroids and small particles are infused through the catheter to block the blood flow to the fibroids. This procedure works for all fibroids that have a blood supply connected to the uterus no matter how many there are or how deeply they may be embedded (unlike myomectomy surgery where not all fibroids can be eliminated).
What Happens to the Fibroids after UFE?
Deprived of their blood supply the fibroids will begin to shrink naturally to less than half their size, and eventually die. They will become soft and will no longer be able to exert pressure on other organs causing discomfort, bloating, pain, frequent urination, heavy bleeding, or other fibroid-related symptoms. Some fibroids may break off and pass out of the body during a normal menstrual cycle. The bottom line: once they are gone, those fibroids are not coming back.
UFE Is a Same-Day Procedure
In most cases, there is no hospital stay required after a uterine fibroid embolization, and the results are permanent. The recovery time is only about 5-7 days and most patients can return to their normal routine after about 10 days. There are no abdominal incisions and the patient leaves the outpatient center with only one small band-aid on their wrist or hip.
Fertility and UFE
There is much misinformation circulating about UFE and infertility. Any procedure or surgery that involves reproductive organs can have fertility risks, but women can and have become pregnant after having UFE.
After a hysterectomy, a woman cannot conceive and have a baby. After a myomectomy, her uterus may be compromised and she may not be able to conceive or carry a pregnancy to full term. Some women are able to get pregnant after a myomectomy, but there is no guarantee.
Many patients have conceived and given birth after UFE at Atlanta Fibroid Center. Many times, fibroids impact a woman’s fertility and once these fibroids are eliminated or reduced in size, conception takes place. Since UFE does not compromise the uterus, women can give birth naturally (without a C-section).
If UFE Works So Well, Why Don’t More Women Know About It?
UFE has been around for almost 30 years, but it has not been as widely publicized as the surgical options. One reason for this is that OB/GYNs do not perform uterine fibroid embolization procedures. When many OB/GYNs see patients with fibroid-related symptoms, they prefer to recommend the surgical procedures that they perform to eliminate fibroids. While some OB/GYNs offer UFE as an option to their patients and refer them to an interventional radiologist, others don’t mention UFE at all.
In today’s world, a woman has to take charge of her health, and getting a second or third opinion is always a good idea. We already mentioned that UFE is performed by an interventional radiologist, but it is very important to find one who specializes in UFE. Not all interventional radiologists are familiar with the complexities of fibroid treatment and most only perform this procedure occasionally. Dr. John Lipman and Dr. Mitchell Ermentrout are experts in embolization and fibroid treatment and perform UFE procedures on a daily basis.
Preserve Your Uterus and Let Fibroids Shrink Naturally
A huge benefit in having UFE to eliminate your fibroids is that it preserves your uterus as well as the rest of your reproductive organs. Even if you have no plans to get pregnant in the future, with what researchers are learning about the uterus and its connections to mental health and other women’s health-related issues, you want to hold onto it!
UFE is considered a minimally invasive procedure, involving some specifically tailored medications and highly-specialized equipment. But after it’s completed, the fibroid shrinking process occurs naturally; there are no additional agents or medications required. It’s recommended to check in with your radiologist in about 3 months after your procedure to confirm that the fibroids continue shrinking naturally and your symptoms are disappearing.
The team of Dr. John Lipman and Dr. Mitchell Ermentrout at Atlanta Fibroid Center® combines over 35 years of academic excellence and extensive medical expertise in treating uterine fibroids. It is our privilege to provide a first-class experience to every one of our patients at Atlanta Fibroid Center®, and we look forward to the opportunity to serve YOU! 90% of women who undergo UFE no longer suffer from fibroid-related systems and get their quality of life back. Before you consider having a myomectomy or hysterectomy to remove fibroids, set up a consultation with Atlanta Fibroid Center®.