How are uterine fibroids treated?
Autore:Uterine fibroids are the most common benign tumours of the uterus (womb). About 30% of women at fertile age will have uterine fibroids. Uterine fibroids are the result of excessive growth of the uterine smooth muscles. The uterine fibroids are usually multiple, of variable size and can be situated anywhere within the uterus.
Symptoms of uterine fibroids
More than half of the women diagnosed with fibroids will have no symptoms. A minority of women are unfortunately suffering very distressing symptoms such as:
- Heavy bleeding during the menstrual cycle (menorrhagia)
- Significant abdominal pain during the menstrual cycle (dysmenorrhea)
- Enlarged uterus (belly appearing larger than normal)
- Pressure to the urinary bladder causing urinary frequency
- A pressure at the bowel causing bloating and constipation
- Pain during sexual intercourse (dyspareunia)
- Infertility (depending on fibroid location)
- Infrequent but potential back and leg pain due to nerve compression.
Diagnosis of uterine fibroids
The above-described symptoms can raise the suspicion of fibroids yet to confirm this, a set of diagnostic imaging is required. The first and most-used imaging examination is the ultrasound scan. That can only provide a limited amount of information. The Magnetic Resonance Imaging (MRI) is the modality of choice as it can guide towards appropriate treatment.
Treatment of fibroids using uterine artery embolisation (UAE)
UAE is performed by an interventional radiologist through “pin-hole” surgery. The procedure will take place, guided by a technologically advanced X-ray machine in an operating theatre environment. The procedure doesn’t require general anaesthesia and only a 2mm nick is necessary at the skin. A fine catheter is passed into the arteries and guided towards the arteries that supply the fibroids (uterine arteries). When the catheter is in an accurate position then specific sized particles are injected to block the blood supply to the fibroids (this is called embolization). As a result, the fibroids die and shrink, but most importantly the symptoms experienced will be resolved.
Benefits of UAE:
- It is a relatively short procedure, typically 30min to 1 hour.
- No general anaesthesia is required.
- There is only a 2mm nick at the skin and no stitches needed.
- Usually requires 24 hours of hospital stay.
- Overall risks of UAE are much lower than surgery.
- Faster return to previous usual activities.
The results of UAE
The satisfaction rate for the procedure is reported being over 90%. The success rate of UAE is more than 80-90% in achieving relief of the presenting symptoms. Usually, no further treatment is required as UAE is treating all fibroids.
