Know about the minimally invasive treatment of fibroids!

By Dr. Vivek Saxena in Radiology , Interventional Radiology

Nov 07 , 2020 | 2 min read

Any women would get petrified when you mention that she has got fibroid tumors. More than 25% fibroids are symptomatic; therefore there is no reason to worry because the threat of malignancy is low.

What are its Symptoms?

It has been seen that 100 out of 1000 women visit the doctor for treatment of fibroids. The symptoms can be often distressing and may include:

  • Menorrhagia
  • Infertility
  • Pressure related pelvic pain
  • Urinary and bowel disturbances

Conventionally, hysterectomy was the mainstay of this condition, while Myomectomy was done in patients who desired fertility. But these surgical procedures are associated with significant morbidity.

Experts use medical treatment with Mirena IUS and gonadotrophim releasing hormone analogues to treat symptomatic fibroids. However, Mirena can only be used in patients having small uterus, without distorting endometrial cavity.

Laparoscopic Techniques-A Major Advancement in Women’s Health

In the past few years, the focus is now on treating the fibroids with uterine preservation. There have been significant advancements in the minimally invasive techniques that have led to the development of uterine sparing treatment modalities for symptomatic fibroids. The two emerging alternative treatment options:

  • Uterine Fibroid Embolisation
  • MRI-guided high intensity focused ultrasound energy

What exactly is Uterine Fibroid Embolization (UFE)?

It is a highly popular and efficacious treatment for uterine fibroids. More than 50,000 procedures have been carried out across the world. It is indicated for most symptomatic fibroids and even adenomyosis of uterus. The contraindications can are: acute or pelvic inflammatory diseases, gynecological malignancy, uncorrected coagulopathy and severe allergy to iodinated contrast media.

Who are the ideal candidates of UFE?

UFE is specially recommended in:

  • Patients who are unwilling or unfit for surgery
  • Obese patients with fibroids
  • Patients with coexistent adenomyosis
  • Patients in which myomectomy is technically challenging as in cervical fibroids
  • Young patients in whom the only surgical option is hysterectomy

Is UFE an efficient procedure?

85-90% of women who have had an UFE experience total relief in heavy bleeding, pain or bulk-related symptoms. The reoccurrence of treated fibroids is rare as evidenced by a study done couple of years’ back, in which a fibroid that had been embolized regrew.

Are there any complications of the procedure?

There can be minor complications like nausea, vomiting and chronic vaginal discharge that is witnessed in approximately 5% of patients. However, major complications are rare and seen in less than 1% of patients. Premature ovarian failure is seen in less than 2% patients and 15% of perimenopausal patients.

What are post-operative complications?

Fibroid embolization usually requires a hospital stay of one night. Pain relief and anti-inflammatory medications are prescribed following the procedure to treat cramping and pain. Many women resume light activities in a few days and the majority of women are able to return to normal activities within seven to 10 days.