An Introduction to Fibroids

By Dayton Interventional Radiology

What are Fibroids?

Fibroids 1Fibroids are non-cancerous growths that develop in the walls of the uterus. They can occur in bunches or alone, and can be very tiny or grow to the size of a cantaloupe. An estimated 70% of all women of reproductive age have uterine fibroids,but most of those experience no symptoms and are never diagnosed. Fibroids are dependent on estrogen for their development and growth, and they are sustained by blood from the uterine artery.

Symptoms

Common symptoms of fibroids include:

  • heavy menstrual bleeding – If you have fibroids, you may be having menstrual periods that last longer than seven days. Women with fibroids can also have very heavy bleeding, requiring new sanitary pads as often as every hour.
  • cramping or abdominal pain – Fibroids can press against other organs in the abdomen and cause pain or cramping.
  • constipation – Larger fibroids can press against the bowels and prevent the passage of waste.
  • incontinence or frequent urination – Fibroids can press against the bladder, leaving less space to store urine.
  • back or leg pain – fibroids pressing on spinal nerves can cause back or leg pain.
  • pain during sexual intercourse – The additional masses inside the uterus can cause pressure on the cervix or uterine walls. This can cause either a dull or sharp pain during intercourse.
  • bloating or distended belly – Fibroids can grow large enough to cause a change in a woman’s shape. The size of fibroids is sometimes described by the month of pregnancy they mimic (i.e., “a four-month fibroid”). It is not unusual for a uterus with fibroids to reach the size of a four- or five-month pregnant uterus.
  • reproductive difficulties – Fibroids that distort the size and shape of the uterus can cause infertility, miscarriages, and premature labor.

Diagnosis

If you are experiencing any of the symptoms described above, you may have uterine fibroids. You should call your usual doctor or make an appointment to talk to one of our doctors. In either case, you’ll discuss your symptoms and be given a standard manual exam to check the shape and size of your uterus. An abnormally shaped or unusually large uterus may indicate fibroids.
Fibroids may also be discovered during your routine annual exam.
If fibroids are suspected, an MRI (magnetic resonance imagery) exam will be performed to confirm the diagnosis and assess the size and shape of the fibroids. Ultrasounds and CT (computer tomography) are also commonly used to diagnose fibroids, but MRIs provide additional distinguishing information so are becoming more widely used. There are other techniques as well, including ones that utilize dye and x-rays or ultrasounds to view the uterus, or hysteroscopy or laparoscopy, which both use cameras to view the uterus from inside the body. Our doctors use MRI as their primary diagnosis confirmation tool.

Risk Factors

The cause of fibroids are as yet unknown, but scientists have been able to determine several factors that can make women more prone to developing fibroids.

  • Fibroids are two to five times more prevalent in black and Asian women than white women.
  • The chance of fibroids is higher in women who are heavy for their height.
  • Fibroids are less likely to occur in women who are smokers
  • Fibroids are less likely to occur in women who have given birth.

Introduction to Uterine Fibroid Embolization

Uterine Fibroid Embolization (UFE) is a 1-hour minimally-invasive procedure that has been proven to effectively relieve the symptoms of uterine fibroids in 85%-95% of symptomatic women. It has been shown to be extremely safe, with complications arising in only 1% of women.

Why Does UFE Relieve Symptoms?

Fibroids are not dangerous or painful in and of themselves, but they can be bulky and can cause problems simply by getting in the way of the body’s natural functioning. For instance, a large fibroid pushing on the colon can cause constipation, or a fibroid pressing on the spinal column can cause leg or back pain. Therefore, the simplest way to relieve the symptoms is to reduce the mass of the fibroid or fibroids. Once the fibroids are smaller, they no longer interfere. UFE relieves uncomfortable fibroid symptoms by shrinking the fibroids.

Uterine fibroids are nourished with blood from the uterine arteries. UFE works by embolizing (blocking) the blood vessels that feed the fibroids to cut off that blood supply. This causes the fibroids to shrink and eventually die. The normal flesh of the uterus will continue receiving blood from other blood vessels, so healthy tissue remains healthy.

How Is It Done?

The blood vessels are blocked by tiny particles about the size of a grain of sand. These particles are made of polyvinyl alcohol (PVA) and have been used for embolization in the human body for over 20 years. The interventional radiologist uses a tiny tube to deliver the particles to the vessels that feed the fibroids. The tube enters your blood femoral artery at your groin and travels to the proper location in the uterine artery.

The procedure takes about an hour and is done in a hospital so that you can be monitored overnight. As the fibroids are deprive of blood and begin shrinking, you may experience cramping and abdominal pain, so pain medication will be delivered intervenously as needed to keep you comfortable. You’ll go home the next day, and will continue to experience some cramping for a few days, but you can control it with over-the-counter medication. You’ll be able to return to normal activities such as work in about 7-10 days.

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Fibroids 5 All Images courtesy of WomensHealth.gov

You can get bids from Dayton Interventional Radiology on MediBid. It is the only full service interventional practice in its state, and they specialize in over 200 minimally invasive procedures including specialization in the treatment of back pain, leg pain, and uterine fibroids.

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