Uterine Fibroid Treatment

Nonsurgical Uterine Fibroid Embolizations (UFE) in Katy

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What are Uterine Fibroids?

Uterine fibroids are benign tumors of the uterus and are the most common cause of abnormal heavy periods.  They can also frequently cause bulk-related symptoms, such as pelvic pain or pressure, bloating, increased urinary frequency, constipation, painful intercourse, or fertility issues.  There are both surgical and non-surgical options for treatment of fibroids, including uterine fibroid embolization (UFE).  Dr. Rafiei is an expert at uterine fibroid embolization (UFE) and has performed over a thousand embolization procedures to treat various health conditions.

Appropriate decision-making for fibroid treatment involves a discussion with a physician familiar with all mainstay therapies.  Dr. Rafiei can help explain these options to you so that you can make an informed decision on your health.   If you have been told you have fibroids and have not discussed UFE as a treatment option with your provider, get a second opinion with Texas IR.  

Surgical Options

Hysterectomy

Hysterectomy is a surgical procedure to remove the uterus and is the most commonly performed gynecological procedure in the United States.  Estimates suggest that one in nine women will undergo hysterectomy during their lifetime and that approximately 600,000 procedures are performed each year in the US.1 The most common reason for a woman to have a hysterectomy is uterine fibroids.  However, hysterectomy carries various surgical risks, such as intraoperative bleeding, infection, surgical adhesions, or damage to adjacent organs like the intestine, urinary bladder, or ureter.  

High Intensity Focused Ultrasound (HIFU)

High intensity focused ultrasound (HIFU) is a procedure that delivers ultrasound energy through the abdomen using an ultrasound probe to generate localized heat to induce fibroid cell death.  This is an outpatient procedure performed with sedation.  Like myomectomy, each fibroid is targeted individually. Compared to HIFU, UFE has a lower reintervention rate and greater improvement in symptoms.8

Myomectomy

Myomectomy is a less-invasive surgical procedure to remove fibroids from the uterus and is an effective uterine-sparing surgery.  This surgery is performed in a hospital under general anesthesia by a gynecologist and usually requires overnight hospitalization with an approximate 4-6 week post-op recovery period.  If you have multiple fibroids, this procedure typically cannot remove all of the fibroids in one procedure.  Also, if you have a large uterus with multiple fibroids, there is a higher risk of bleeding and for conversion from myomectomy to hysterectomy.  Myomectomy has a higher fertility rate compared to UFE,2-4 and some gynecologists will tell patients that UFE should be avoided if they’re interested in fertility.  But, many studies show that pregnancy is attainable for females after UFE with an approximated fertility rate of 38.3% compared to 56% for myomectomy.5-6  Both myomectomy and UFE have been linked to high quality life scores following each procedure.7

Laparoscopic Radio-Frequency Ablation

Laparoscopic radio-frequency ablation is a surgical procedure performed under general anesthesia where a laparoscope (small camera) is inserted into the body with an ablation probe through small incisions.  The ablation probe is inserted individually into each fibroid to heat the tissue to destroy the fibroid.  The fibroids shrink to improve symptom frequency and severity.  This procedure is not recommended for large fibroids or for women interested in future pregnancies.

Endometrial Ablation

Endometrial ablation (cryoablation, microwave ablation, RF ablation, heated fluid, etc.) is a procedure performed by a gynecologist used to treat heavy menstrual bleeding.  The procedure destroys a layer of the uterine lining and reduces the flow of menstruation.  It does not have an effect on the fibroids.  Patients who desire future pregnancy should not have an endometrial ablation. 

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Uterine Fibroid Embolization (UFE)

UFE is a minimally invasive uterine-sparing treatment option that treats all fibroids in the uterus.  UFE is approximately 85% effective in alleviating heavy bleeding and bulk-related symptoms.  Compared to hysterectomy or myomectomy, UFE has a reduced procedure length, reduced hospital stay, quicker return to routine activities, and decreased risk of blood transfusion.9  Rare complications include premature menopause in women over age 45 or fibroid expulsion from the uterus.10  

UFE is an outpatient procedure performed at our office-based lab.  The procedure involves placement of a small catheter through the groin or wrist artery.  The catheter is then advanced into the uterine arteries that supply blood to the fibroids followed by injection of small particles to cut off their blood supply.  Patients have about a 3 hour recovery after the procedure and are discharged home the same day.

References:

  1. Wu JM, Wechter ME, Geller EJ, et al. Hysterectomy rates in the United States, 2003. Obstet Gynecol 2007;110:1091–5.
  2. Van der Kooij SM, Bipat S, Hehenkamp WJ, et al. Uterine artery embolization versus surgery in the treatment of symptomatic fibroids: a systematic review and metaanalysis. Am J Obstet Gynecol 2011; 205:317.e1-18.
  3. Mara M, Maskova J, Fucikova Z, et al. Midterm clinical and first reproductive results of a randomized controlled trial comparing uterine fibroid embolization and myomectomy. Cardiovasc Intervent Radiol 2008; 31:73.
  4. Homer H and Saridogan E. Uterine artery embolization for fibroids is associated with an increase risk of miscarriage. Fertil Steril 2010; 94:324.
  5. Ludwig PE, Huff TJ, Shanahan MM, Stavas JM. Pregnancy success and outcomes after uterine fibroid embolization: updated review of published literature. Br J Radiol 2020; 93: 20190551.
  6. Pisco JM, Duarte M, Bilhim T, et al. Spontaneous pregnancy with a live birth after conventional and partial uterine fibroid embolization. Radiology 2017; 285(1)302-310.
  7. Manyonda, IT, Bratby, M, Horst, JS, et al. Uterine artery embolization versus myomectomy: impact on quality of life–results of the FUME (Fibroids of the Uterus: Myomectomy versus Embolization) Trial. Cardiovasc Intervent Radiol, 2012; 35(3): 530-536.
  8. Laughlin-Tommaso S, Barnard EP, AbdElmagied AM, et al. FIRSTT study: randomized controlled trial of uterine artery embolization vs focused ultrasound surgery. Am J Obstet Gynecol 2019; 220:170.e1.
  9. Gupta JK, Sinha A, Lumsden MA, Hickey M. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database of Syst Rev 2012; 5:CD005073.
  10. Memtsa, M. and Homer, H. Complications associated with uterine artery embolization for fibroids. Obstet Gynecol Int 2012: 290542.

Find Your Way to Better Health

At Texas IR in Katy, we’re committed to offering personalized, non-surgical treatment for fibroids for Houston area patients that prioritizes your comfort and well-being. Our Katy office provides compassionate care with minimally invasive uterine fibroid embolizations for patients across Houston, Sugar Land, Richmond, Fulshear, and other nearby communities. Whether you’re seeking fast recovery with our non-surgical embolization treatments or looking for personalized care in a comfortable, outpatient setting, we’re here to make the process easy. Schedule your consultation today and experience care tailored to your needs.