Uterine fibroid embolisation - another treatment option
The occurrence of fibroids in women is very common in Jamaica, and black women have fibroids more frequently and experience more severe symptoms. These symptoms include bleeding, pain, pressure symptoms on the urinary bladder and reproductive difficulties. The symptoms can become debilitating for some women, requiring therapy.
There are various ways of treating fibroids, ranging from medical to surgical and more recently, non-surgical techniques such as uterine fibroid embolisation (UFE).
UFE is a non-surgical procedure in which a small flexible tube is inserted into the blood vessels that supply the uterus and an embolic agent (polyvinyl particles a substance which clogs blood vessels) is injected. This decreases the blood flow to the uterus and, in turn, the fibroids. The end result is that the fibroids do not have enough blood supply to survive and subsequently shrink.
This technique is very useful for women who would rather not have surgical scars, be anaesthetised for surgery or have their uterus removed. It is also very useful for those who are unable to undergo surgery for medical reasons or for those who are unable to receive transfusions, as the blood loss from UFE is usually negligible.
Although pregnancy may be possible after UFE, it is not intended for women who strongly desire future fertility. Also, women with very large fibroids (equal to a 24-week- old pregnancy or more) derive less benefit.
Recovery after this procedure is generally shorter than that of surgery. A short hospital stay of two days is required, after which five days of recovery is continued at home.
UFE in general improves quality of life to a degree equal to that of hysterectomy within the first 10 years.
Some recurrence or regrowth of fibroids can occur and a repeat procedure in some cases is needed.
In most cases, however, one procedure lasts long enough to carry the patient into menopause, at which point fibroids are less of a concern.
In summary, uterine fibroid embolisation represents a viable option for women who require intervention to mitigate the symptoms of fibroids and to improve their quality of life.
• Dr Steven Lofters is a gynaecologist and UFE specialist in Jamaica. Email: