Uterine fibroid embolization or UFE is one of the biggest medical breakthroughs for women suffering with uterine fibroids. Dr. Lipman and the Atlanta Fibroid Center has one of the world’s largest experience in this amazing procedure . He was the first to perform UFE in Georgia and has treated over 7,000 women over the past 23 years.
Despite the very long track record of safety and efficacy of the UFE procedure, most women suffering with fibroids and seeking help from their Ob/Gyn will not hear about this amazing procedure.
Therefore, the first myth that you may hear from your doctor is “Your only option to treat your fibroids is surgery” (either hysterectomy if you’re not interested in fertility, or myomectomy if you are).
Video: 4 UFE Myths You May Hear from Your Doctor
Why would your doctor not tell you about UFE if they know about this non-surgical option? Quite simply many Ob/Gyns would rather attempt to treat the patient with surgery as they are trained surgeons. But a survey of nearly 1,000 women in the U.S. published in the American Journal of Obstetrics & Gynecology and the Journal of Women’s Health in 2013 revealed that the average time for women suffering with fibroids to seek treatment was over 3 ½ years; with 1/3 of them waiting for 5 years (1).
When they asked the women why they waited to be treated, the majority of them said they did not want surgery. They wanted a non-surgical option, and UFE was not typically mentioned to these women.
The fact that most women suffering with fibroids did not want surgery was surprising to the gynecologists that reported on this data. But not to Dr. Lipman. He sees many women every day in his office at the Atlanta Fibroid Center that are not interested in surgery. They are specifically looking for cutting edge procedures that are safer than surgery, less invasive, have a much quicker recovery, and allow them to keep their uterus.
UFE is a completely non-surgical outpatient option, which treats every fibroid in the uterus and just the kind of procedure these women are looking for. Unfortunately, most women aren’t told about the UFE option.
Myth 1: What [Really] Happens After a Partial Hysterectomy
The second myth is that a partial hysterectomy only removes a part of the uterus. A partial hysterectomy removes the entire uterus and leaves the ovaries behind, whereas a complete hysterectomy removes the uterus AND the woman’s ovaries. The theoretical advantage of a partial vs. a complete hysterectomy is that patients undergoing a partial hysterectomy wouldn’t go in to menopause immediately after the surgery.
However, 1/3 of patients that underwent partial hysterectomy did go into menopause immediately, and another 1/3 of patients went in to menopause early. Removing any part of the uterus for benign fibroids is completely unnecessary and often results in significant psychological (like a man being castrated) and sexual side effects. It also causes significant bone loss and frequent urinary issues (ex. leaking or incontinence); not to mention the 25% surgical complication rate.
Myth 2: You Can’t Have Children after UFE
Dr. Lipman has seen numerous children born after UFE, including three sets of twins. Births after UFE are typically full term and vaginal.
Photo: Doris Combs’ letter to Dr. Lipman nearly 18 years after her UFE procedure at Atlanta Fibroid Center. Read the full story of Doris Combs and her miracle baby.
The surgical alternative is called a myomectomy. This surgical procedure attempts to surgically remove the biggest fibroids from the uterus and then sew the uterus back together. There are a number of issues with the surgical myomectomy. The first is that there are often way more fibroids in the uterus than the surgeon can remove. This means that there are often many fibroids left behind after surgery that will grow, and within 3-5 years the patient will need a second procedure (either the second myomectomy, hysterectomy, or UFE). Dr. Lipman has seen numerous women with more than 2 myomectomies; some with as many as 5 (and they’re seeing him to learn about UFE as a 6th procedure)!
There is never a reason to do more than 1 myomectomy, but if you are unaware of UFE and don’t want hysterectomy, you will likely end up with a myomectomy. A myomectomy has significant effects on a woman’s fertility and there is very little fertility left after 2 myomectomies.
If a woman undergoes a myomectomy and then becomes pregnant, she is obligated to undergo a C-section. This is in contrast to UFE, where the births are typically full-term and vaginal. Therefore, with myomectomy, you will likely end up with multiple surgeries (myomectomy plus a c-section) and still need another procedure in 3-5 years to treat the recurrent symptoms from the fibroids that were left behind at the original surgery (myomectomy). Again, contrast that with UFE and vaginal birth with no surgeries.
Myth 3: You Are NOT Qualified for UFE
The fourth myth is that a woman with symptomatic fibroids wouldn’t qualify for UFE because of the size of her uterus or the number of fibroids that she has. This is completely false. It does not matter how big or how numerous the fibroids are. No matter what your doctor tells you about qualifying for UFE, if you’re a candidate for hysterectomy, you’ll be a candidate for UFE.
Myth 4: You Will Eventually Need a Hysterectomy Anyway
Myth number five is that if you have UFE, you will need a hysterectomy someday anyway. The vast majority of UFE patients find the relief they are looking for and are symptom-free forever; particularly if they are over 40 years of age at the time of the UFE. Younger patients have a longer time horizon until menopause and may grow new fibroids but this is not typical.
The Biggest Myth of Them All: You Don’t Need Your Uterus
If you are not interested in having children at any point in the future, your doctor may imply that you don’t need your uterus anyway. After all, its key function is to bear children, and therefore, if you are not going to have kids, it’s better to “just be done with it for good”. In those cases, your doctor may suggest a partial or a full hysterectomy as an option.
While there are many good reasons for a woman to consider and have a hysterectomy, uterine fibroids are not one of them. We say it with confidence because the truth is that your uterus has a much bigger purpose and role in your life than bearing kids. In fact, its purpose in your body is so important that we will dedicate a separate post to the subject to cover it in detail, but for now, it’s important to mention that removal of uterus can affect your hormonal balance, sexuality, and even personality and overall physical and mental health.
A hysterectomy, whether partial or full, has a 30% complication rate. Many of these are due to bleeding with transfusion or wound issues, but there can also be significant morbidity from cutting important structures during surgery (exs. bladder, bowel, ureter) or even on rare occasion death.
The UFE procedure is much safer than surgery and allows women the relief of symptoms, spares them from the risks and long recovery of surgery, and allows them to keep their uterus.
Conclusion
Choosing the best way for you to treat fibroids is not an easy task. A lot depends on your individual circumstances and needs. But one thing for sure: you want to have accurate information about your options at your disposal in order to make the right choice. That’s why it’s important to speak to both, your OB/GYN AND an experienced interventional radiologist like Dr. Lipman, to understand what will work for you.
References
(1). Bijan J. Borah, Wanda K. Nicholson, Linda Bradley, Elizabeth A. Stewart. The impact of uterine leiomyomas: a national survey of affected women. American Journal of Obstetrics and Gynecology, 2013; 209 (4): 319.e1 DOI: 10.1016/j.ajog.2013.07.017
