WHAT ARE UTERINE FIBROIDS?

Fibroids are non-cancerous growths in or on the walls of the uterus. They are very common and range in size from very small to very large.

Most often occurring in women from their 30s to early 50s, uterine fibroids can affect any woman of reproductive age. In most cases, they cause no symptoms and are discovered incidentally during a pelvic exam or ultrasound.

WHAT ARE THE SYMPTOMS OF FIBROIDS?

Fibroids that cause symptoms may need to be treated. Some common symptoms of uterine fibroids include:

• Bloated and swollen abdomen
• Constipation
• Frequent urination
• Heavy and prolonged menstrual bleeding
• Nocturia (having to get up to urinate in the night)
• Painful menstrual periods
• Pressure and pain in the abdomen and lower back

HOW ARE FIBROIDS TREATED?

Fibroids that cause pain and bleeding, or otherwise affect quality of life, have traditionally been treated by medications or surgery. Surgical options generally include hysterectomy (removal of the uterus) or myomectomy (surgical removal of fibroids from the uterus).

There is also a minimally invasive alternative to surgery, called uterine fibroid embolization (UFE). It’s used to block blood flow to fibroid tumors of the uterus. An interventional radiologist uses X-ray guidance to move a small plastic tube through the groin and into the small arteries which are feeding the fibroids. Then tiny particles are injected into the arteries to starve the fibroid of its blood supply, shrinking it.

HOW DOES UFE COMPARE TO SURGERY?

First performed in 1994, UFE has proven to be a safe and effective treatment for symptomatic uterine fibroids. It is less invasive and has fewer complications compared to surgery. Hospital stay following a UFE procedure is less than 24 hours and recovery from the procedure is fast with patients often returning to normal activities within a week.

In contrast, post-surgery hospital stay could be up to 2-3 days and return to work or normal activity could take about a month or longer. Hysterectomy has also been associated with negative impact on cardiovascular health of women along with long-term physical effects, such as incontinence and loss of sexual pleasure.

With surgical options relief from fibroid symptoms is rapid upon recovery from surgery. Whereas after a UFE procedure the fibroids are slowly deprived of blood supply, so it may take up to 3-6 months for you to see the full benefit, although you should start to feel better in less than a month.

HOW DO I GET UFE?

Mayfair Diagnostics interventional radiologists perform these embolization procedures in-hospital within Calgary. These procedures are covered under the Alberta Health Care Insurance Plan. Out-of-province patients are accepted; you would need to confirm with your provincial health care plan that they will cover the procedure as Alberta Health Services (AHS) will bill your provincial plan.

If you think you might benefit from this procedure, you will need to speak with your family doctor or specialist. Your doctor or specialist will then need to fax a consultation request to Rockyview General Hospital’s Diagnostic Imaging department at 403-592-4852.

Once the information has been received, our interventional radiology team will review the request and contact you to arrange a consultation to determine if the procedure is appropriate based on your medical history. There may also be imaging required. For example, a CT or MRI scan of the uterus may be ordered.

REFERENCES

Mayo Clinic Staff (2022) “Uterine fibroids.” www.mayoclinic.org. Accessed April 15, 2022.

Spies, J.B. (2013) “Current Evidence on Uterine Embolization for Fibroids.” Seminars in Interventional Radiology. 30(4): 340–346. Accessed April 15, 2022.