Uterine fibroids are noncancerous growths of the uterus and affect millions of women worldwide. These benign tumors can cause a range of symptoms, from heavy menstrual bleeding and pelvic pain to reproductive issues. For many years, hysterectomy, the surgical removal of the uterus, was the primary treatment option for women with severe fibroid symptoms. However, in recent years, a less invasive alternative has gained popularity – Uterine Fibroid Embolization (UFE). In this blog, we will explore uterine fibroids, their impact on women’s health, and why UFE may be a preferable treatment option over hysterectomy.

Understanding Uterine Fibroids

Uterine fibroids, also known as leiomyomas or myomas, are noncancerous growths of the uterine muscle. They can vary in size, from tiny seedlings to large, grapefruit-sized masses. While some women may have fibroids and never experience symptoms, others can suffer a wide range of problems that significantly impact their quality of life. Common symptoms include:

1. Heavy menstrual bleeding
2. Pelvic pain and pressure
3. Frequent urination
4. Pain during intercourse
5. Lower backache
6. Infertility or recurrent miscarriages

These symptoms can be debilitating, affecting a woman’s physical and emotional well-being. Historically, when fibroids caused severe symptoms or other complications, a hysterectomy was often recommended as the ultimate solution.

Hysterectomy vs. Uterine Fibroid Embolization (UFE)

Hysterectomy involves the complete removal of the uterus, making it an effective treatment for uterine fibroids. However, it is a major surgery with long recovery times, potential complications, and irreversible consequences. For many women, the prospect of losing their uterus, and thereby their ability to conceive and bear children, can be emotionally distressing. Additionally, the recovery period for a hysterectomy can be several weeks, impacting work, family life, and overall well-being.

Uterine Fibroid Embolization, on the other hand, offers a minimally invasive alternative. This procedure, also known as UFE, involves a radiologist inserting a tiny catheter into the blood vessels supplying the fibroids. Small particles are then injected through the catheter to block the blood flow to the fibroids, causing them to shrink and die. UFE is performed under local anesthesia, often on an outpatient basis, with a significantly shorter recovery time compared to hysterectomy.

Advantages of Uterine Fibroid Embolization (UFE)

1. Preservation of Fertility: One of the most significant advantages of UFE is that it allows women to preserve their fertility. Unlike hysterectomy, where the uterus is removed, UFE merely shrinks the fibroids, leaving the uterus intact. This is crucial for women who wish to have children in the future.
2. Minimally Invasive: UFE is a minimally invasive procedure that avoids large abdominal incisions. This leads to reduced pain, shorter hospital stays, and a faster recovery compared to the more invasive hysterectomy.
3. No Hormonal Changes: Hysterectomy can trigger hormonal changes, leading to early menopause. UFE doesn’t interfere with hormonal function, allowing women to maintain their natural hormonal balance.
4. Effective Symptom Relief: UFE is highly effective in relieving fibroid symptoms, with studies showing that over 85% of women experience significant improvement.
5. Reduced Risk: Since UFE doesn’t involve major surgery, it comes with fewer risks of infection, excessive bleeding, and other surgical complications.
6. Cost-Effective: UFE tends to be more cost-effective than hysterectomy, considering the shorter hospital stay and recovery time.

Uterine fibroids can significantly impact a woman’s quality of life, causing distressing symptoms and reproductive issues. While hysterectomy has long been the standard treatment, Uterine Fibroid Embolization (UFE) offers a compelling alternative for women who wish to avoid the irreversible consequences of hysterectomy. UFE is minimally invasive, preserves fertility, and provides effective symptom relief.

Ultimately, the choice between UFE and hysterectomy depends on the individual circumstances, the severity of fibroid symptoms, and the patient’s reproductive goals. Consulting with a board-certified interventional radiologist at Radiology of Indiana to discuss the available options is crucial for making an informed decision regarding the most suitable treatment for uterine fibroids. To learn more visit radiologyofindiana.com or call (317) 621-5555.

Fibroids are non-cancerous (benign) tumors that grow from the muscle layers of the uterus and affect at least 20 percent of women sometime during their lifetime. Depending on their size and location, fibroids may cause no symptoms at all or a variety of complications.

There are four primary types of uterine fibroids, classified by location:

Intramural

The most common type of fibroids, intramural fibroid tumors develop within the muscles of the uterine wall and often expand from there. When an intramural fibroid expands, it tends to make the uterus feel larger than normal and can cause excessive menstrual bleeding, prolonged menstrual cycles and clot passing, frequent urination, and back and pelvic pain caused by the additional pressure placed on surrounding organs.

Submucosal

The least common type of fibroids, submucosal, are located in the muscle under the uterine lining (endometrium) and may protrude into the uterine cavity. Submucosal fibroids can cause heavy bleeding, prolonged menstrual cycles, and the passing of clots. Left untreated, prolonged or excessive bleeding can cause more complicated problems, such as anemia and fatigue. Submucosal fibroids are also most closely linked to fertility problems, as large tumors can block the fallopian tubes.

Subserosal

Subserosal fibroids grow on the outer wall of the uterus. They can become quite large, continuing to grow outward and putting increased pressure on surrounding organs. This type of fibroid does not usually interfere with a woman’s menstrual flow or cause excessive bleeding but can cause pelvic pain and pressure.

Subserosal, as well as submucosal, fibroids can sometimes develop into pedunculated fibroids, meaning they grow on a stalk. Pedunculated fibroids can twist on the stalk, causing additional pain and pressure.

Cervical

Cervical fibroids are located in the wall of the cervix, the neck of the uterus. The most common symptom is irregular or heavy bleeding. Cervical fibroids can also cause painful sexual intercourse, vaginal discharge, or trouble with urination.

Women generally have multiple fibroids, and it is possible to have more than one type, making it difficult to determine which fibroid is causing symptoms.

If you are experiencing any of the following symptoms, you may have uterine fibroids:

• painful, heavy periods
• pelvic or back pain
• frequent or difficult urination
• swelling in the abdomen
• painful intercourse

You’ve talked to your OB-GYN about your uterine fibroid diagnosis and possible treatment options. So…what’s the next step?

If you and your OB-GYN have determined that a treatment option such as Uterine Fibroid Embolization (UFE) might be right for you, it’s time to see a specialist, particularly an interventional radiologist, who can evaluate whether or not you are indeed a good candidate for the procedure.

Once referred to a specialist, you should take a copy of your medical records and any imaging that has confirmed your fibroid tumors to your consultation. A copy of your most recent gynecologic evaluation is also helpful, as an OB-GYN exam is recommended to rule out non-fibroid causes of symptoms.

To help you understand UFE as a procedure, and also to help you understand how the physician will manage your case, it is important to ask lots of questions. Below is a list of questions you may want to ask your specialist so that you can be prepared to make the best decision about your fibroid treatment.

• How would you coordinate my care with my OB-GYN?
• Which OB-GYNs refer patients to you for UFE?
• How often is the procedure successful in treating uterine fibroids?
• Are your patients happy with the procedure?
• What are typical complications, and how often do complications occur?
• How will I feel during and after the UFE procedure?
• How long should I expect to be away from work?
• What is the length of the procedure? What is the normal recovery time?
• How long should I expect to stay in the hospital?
• What kind of follow-up care is typical, and who manages it?
• What typically happens to the fibroids after the blood supply is cut off? Should I expect them to be expelled vaginally, or will the procedure simply result in my fibroids shrinking?
• Will my fibroids, or the symptoms of my fibroids, come back?
• Will I still get my periods after having UFE, and what will they be like?
• Will my insurance cover Uterine Fibroid Embolization?
• Can you help me determine if I am a candidate for UFE, and when can we schedule the procedure?

If you’re considering Uterine Fibroid Embolization (UFE) to treat your fibroid symptoms, you most certainly have many questions. “Will I have to stay overnight in the hospital?” “Is the procedure painful?” “How long will my recovery be?”

One question that may also be on your mind—“Will my insurance cover UFE?”

Although all insurance companies and policies differ, the answer is most likely yes. You may be responsible for a portion of the cost—depending on your individual plan, your deductible amount, and what percentage of the cost will be paid by the insurance company—but UFE is covered by most insurance providers.

Before having any procedure, of course, you should do your homework and check with your insurance provider to verify your plan and benefit coverage. Know ahead of time what your financial responsibility will be and if you’ll need any specific referrals or preauthorizations before undergoing UFE.

Be sure to ask your health insurance provider the following:

• Is a referral by my primary care physician required for consultation with a radiologist?
• Is my interventional radiologist considered in-network?
• Is pre-certification required for UFE’s pre-procedural pelvic MRI?
• Is pre-certification required for my UFE procedure?

At Interventional Physicians of Indiana, we are here to help with all aspects of your fibroid treatment—including the financial part. We will work with you to submit your health insurance claim and will try to answer any questions you may have about your coverage. We participate with many medical groups to provide healthcare service to their HMO members and PPO healthcare plans.

We are in-network with a number of health insurance providers. You can find a general list of insurance providers we work with here. However, be sure to check with your provider directly to verify your specific plan and benefit coverage.