Uterine artery embolization is a minimally invasive procedure often used to treat fibroid tumors. Small polyvinyl particles are injected into the uterine artery while the patient is under xray examination. The goal is to block the blood supply to the tumors so they eventually die off. The technique has been successful for small, single tumors and may be an option for some women. Unlike our Female Alternative Surgery, UAE is not recommended for patients hoping to maintain fertility. Many physicians are attempting to embolize larger and multiple tumors, creating the potential for damage to surrounding uterine muscle and eventual uterine abcess. This can necessitate hysterectomy. We do not recommend UAE for women with multiple or larger fibroids or those hoping to maintain fertility.
I recently had a patient in the office with very large fibroids…she had had two previous myomectomies with her gynecologist and she was wondering why her tumors had returned. Sadly, the recurrence rates for fibroid tumors following surgery can be as high as 60%…the well known fact is that most of these tumors have not grown back since surgery, but were never removed during the inital procedures. Fibroids that are deep in the uterine muscle are difficult to access without significant blood loss…as a result, many gyns will not remove the deeper tumors. This sets women up for multiple fibroid tumor surgeries. Our recurrence rates are approximately 2%, as we are able to remove all fibroids, regardless of size or location (submucosal, subserosal) employing vascular techniques that prevent bleeding. If you are considering a myomectomy ask your doctor about their success rates, in reference to minimizing the need for future surgery.
Traditional medicine has routinely rcommended removal of the uterus, hysterectomy, for uterine and ovarian malignancy, however physicians also advocate hysterectomy for benign diseases like fibroids, adenomyosis, and endometriosis. Recent studies (LA Times article, published August 10, 2009 entitled “Staying Fertile after Cancer”) on Stage 1 ovarian cancer patients have found that preserving the uterus and unaffected ovary have the same 5 year survival rates as removing all organs. If medicine is changing to reduce hysterectomies for certain cancers, lets hope they will eventually see the need to prevent hysterectomy for benign diseases as well.
Many of our patients try supplements and herbal formulas prior to seeking a medical consultation. Although these therapies can help reduce symptoms temporarily, they will become ineffective over time as the disease spreads. Supplements and herbal formulas are not regulated by the FDA and therefore quality, strength and dosage cannot be guaranteed. Delaying appropriate treatment can sometimes be detrimental. Fibroid tumors, adenomyosis and endometriosis all require surgery is remove the disease…treating symptoms does nothing to treat the condition or the tumors. Using these alternative therapies, after surgery , may be helpful in preventing recurrence, but should not be the only source of treatment. Consult your physician and do some research about what is the best course of treatment for your disease.
Routinely in my consultations, I get asked to explain some of the minimally invasive treatments for fibroids. Today I want to discuss Endometrial Ablation. This is a very common procedure often recommended by the gynecologist for patients with heavy bleeding. This technique basically destroys the lining of the uterus, known as the endometrial lining. It can be destroyed using various different techniques with either heat or cold. All ultimately do the same thing…..this procedure significantly reduces bleeding but if the ablation is incomplete…lining can regenerate over time and bleeding return. This is a treatment for heavy monthly periods, but not a direct treatment for fibroid tumors or adenomyosis.