Fibroids are benign growths (not cancer) in the muscular wall of the uterus. These growths can be very tiny or as large as a cantaloupe.
Fibroids are very common. At least 20% of women 35 years of age or older have fibroids. Many women have them without knowing it. Black women are at a higher risk of having fibroids than women in other racial groups.
Many women who have fibroids don't have symptoms. In other women, fibroids can cause heavy bleeding during the menstrual period. Periods may last much longer than usual.
Fibroids may also cause pain or a feeling of pressure or heaviness in the lower pelvic area (the area between the hip bones), the back or the legs. Some women have pain during sexual intercourse. Others have a constant feeling that they need to urinate. There may also be a feeling of pressure in the bowel. Some women have constipation or bloating.
There are many treatments for women with fibroids. Medicine can shrink some fibroids, but women who take these medicines may have significant side effects. Some women need surgery. A newer way to treat women who have fibroids is called uterine fibroid embolization.
Fibroids need to have a large blood supply to grow. Fibroids will shrink or go away completely if the blood supply is stopped. Embolization means stopping or blocking the blood flow. So, uterine fibroid embolization is a way to stop the blood flow that makes uterine fibroids grow. The procedure works even if you have several fibroids.
Uterine fibroid embolization is not surgery, but it's done at a hospital. You will be given medicine to make you relaxed, but you won’t be under general anesthesia (totally “asleep”). The procedure doesn't cause pain. The doctor (an interventional radiologist who is specially trained to do this procedure) will make a tiny cut in the skin in your groin area. Next, the doctor will pass a tiny tube called a catheter through an artery to your uterus. When the catheter is in place, the doctor will inject tiny particles into the catheter. These particles, made of plastic or gelatin sponge, are about the size of grains of sand. These particles move through the catheter into the arteries that send blood to the fibroid. The particles will stop the blood flow to the fibroid. Over time, the fibroid will shrink in size.
This procedure is typically very successful. Several studies have shown that 85% to 95% of women have improvement in abnormal bleeding. About 80% of women have a lot or total relief of pain and 60% to 96% of women have improvement in pelvic pressure or heaviness.
There are several advantages to uterine fibroid embolization over surgery. Usually, you only have to stay in the hospital one night after the procedure. You can return to your normal activities about a week after the procedure. This is a shorter time compared to the recovery period after surgery. There's no significant blood loss. There's no big surgical incision. You don't need general anesthesia.
Uterine fibroid embolization is safe, but there are some risks and side effects. Most women have moderate to severe cramps for the first few hours after the procedure. Some women have nausea and fever. Medicine can help with these symptoms.
A few women get an infection after the procedure. Antibiotics can control the infection. A small percentage of women have an injury to the uterus from the procedure. This could make a hysterectomy (surgical removal of the uterus) necessary.
In about 20% of women who have successful uterine fibroid embolization, fibroids grow back after a few years. These women may need to have the procedure again or may need surgery.
Doctors don’t have a lot of information about how uterine fibroid embolization affects a woman’s ability to get pregnant. Make sure your doctor knows if you’re considering getting pregnant in the future. He or she may recommend surgical removal of the fibroid (called myomectomy) instead.
Written by familydoctor.org editorial staff