Fibroids are muscular tumours which grow in the wall of the uterus and are almost always benign. They can be as small as a seed or as large as a grapefruit. It is estimated that 70 per cent of women will have one or more uterine fibroid by age 50, with 30 per cent experiencing symptoms. It is not known what causes fibroids but we do know that they are under hormonal control (both oestrogen and progesterone).
They thus grow rapidly in pregnancy when hormone levels are high which, in some cases, can lead to multiple problems in the pregnancy. It is commonly diagnosed among women in the 30-40 age group, many of whom require medical interventions to treat their symptoms.
Ultrasounds are most commonly used to detect the presence and dimensions of fibroids. Once symptomatic fibroids are diagnosed, women are presented with the options of medical or surgical management, with many of them eventually needing surgery.
The high cost and possible risks involved in surgery have opened up interest in the alternative treatment option of uterine artery embolisation, also known as uterine fibroid embolisation (UFE) which is a well established, minimally invasive procedure used to treat symptomatic uterine fibroids. It is performed by an interventional radiologist and is a possible alternative to surgical treatment (hysterectomy or myomectomy) which are the most common treatment options for fibroids.
Since the introduction of UAE there has been strong evidence for its efficacy, along with its low rate of complications.
So what exactly is UAE?
Simply put, UAE involves the use of a tube or catheter inserted in the arm or groin to inject small particles into the uterine arteries which supply blood to your uterus and fibroids.
These particles block blood flow to fibroids, starve them, and cause them to shrink, resulting in improvement in symptoms. X-rays are used to see your blood vessels and uterus in real time via a monitor. This allows your doctor to successfully navigate the catheter through your blood vessels.
Symptoms of fibroids
Not all women with fibroids have symptoms. Women who have symptoms often find it difficult to cope. These symptoms include:
1. Heavy, long or painful periods
2. Severe pain in the pelvis or back and legs
3. Pain during sexual intercourse
4. Bladder pressure and frequent urination
5. Constipation from bowel pressure
6. An abnormally enlarged abdomen
Effectiveness of UAE
UAE is safe, tolerable and effective both in the short and long term. Eighty to 95 per cent of women who had the procedure experienced significant symptomatic relief. Recurrence of fibroids ten years after treatment is unusual and it is effective for both small and large fibroids. Best of all, recovery time is quick as there is no incision and no use of general anaesthesia. UAE also helps restore fertility in women as there are numerous reports of pregnancies following this treatment.