What is the Uterine Fibroid Embolization (UFE) procedure like?

 

UFE is a relatively quick and less invasive treatment, and often you are sent home the next day, depending on where you have the procedure. Dr. Suzanne Slonim, M.D., describes the process from the patient’s perspective.

“So from your perspective, you’re going to come into the hospital, in the morning, the nursing staff is going to do a whole lot of things, they’re going to start an IV, they’re going to give you some medicines, they’re going to draw some blood, we’re going to check you out the morning of the procedure, we’re going to take you into the procedure room and put you to sleep. They will put a catheter in your bladder, and then I’m going to do the procedure, you’re not going to have any awareness of it. You’re not going to remember it at all.”

“As soon as the procedure is done, we’re going to bring you back into the holding room, and I’m going to hook you up to the pain pump. I’m going to stand at your bedside and make sure that you’re comfortable and not in pain, and hook you up to the pain pump, then the nurses will watch you. I will always be hovering around close by so that if there are any issues I usually tell, women usually bring their mother or their husband with them, and I usually tell them if there is any problems that are not being addressed please come and find me, and I’ll take care of it.”

“You’ll stay in my holding room until late in the afternoon. I do that for two reasons. One is my nurse is going to watch you a lot closer than the nurses upstairs. Two, is that most of these are done on a 23-hour admission, that 23 hours starts when you get up to the unit, up to the floor, and I don’t want tomorrow for anyone to be saying, listen Dr. Slonim, it’s time for her to go.”

“I want to make sure you’re ready to go before you leave. So, you’ll stay in my area until late in the afternoon, you’ll go up to the floor, and you’ll be in the hospital room overnight.”

See Dr. Linda Hughes’ answer to this question.

 

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Are there medications or natural remedies used to treat fibroid symptoms?

 

Dr. Slonim explains that some women take Lupron to treat fibroid symptoms. However, she explains how most women decide not to take it due to the hormonal side effects.

“You’re probably talking about Lupron, which is a hormone that will signal your body to cut down the hormones that cause the fibroids to grow. It’s effective in helping the symptoms of smaller fibroids, but most women feel uncomfortable while they’re on it, it causes the same kind of symptoms you may have when you’re on birth control, it can be swelling bloating, mood swings, just feeling lousy, so a lot of women don’t like to take it.”

“Also, when you stop it the fibroids symptoms come back. If you’re taking Lupron, I want you to be off it for a month before I do the procedure because one of the things that it does is, shrink the blood vessels to the fibroids, I need those blood vessels to be big and juicy, while I do the procedure.”

See Dr. Linda Hughes’ answer to this question.

 

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Is it always necessary to treat fibroids?

 

Most women with fibroids do not show symptoms, and in that case, it is usually not necessary to treat fibroids. Dr. Slonim, M.D., explains.

“Absolutely not. We treat them if they’re causing symptoms, that are enough for a woman to want to have something to be done about it. The symptoms that we usually treat are bleeding, and bulk symptoms, and any ancillary problems caused by the bulk symptoms. So if a woman comes to me because she’s found out from an ultra sound, or an MRI that she has fibroids, but they’re not causing her any symptoms, I’m going to talk her out of having a procedure.”

See Dr. Linda Hughes’ answer to this question.

 

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How can an enlarged uterus from fibroids be similar to pregnancy?

 

Dr. Slonim explains below that an enlarged uterus has similar symptoms to pregnancy.

“Having an enlarged uterus can cause similar symptoms as pregnancy if the uterus is pressing on the bladder causing urinary frequency, if the uterus is pressing on the rectum causing constipation. Just the general discomfort of the bulk symptoms, you can feel a mass in your abdomen, as it grows your clothes cannot fit you right. I’ve had patients where the uterus presses on the nerves against the spine, and causes pain down the legs, if it presses on the veins, it could cause swelling in the legs.”

 

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What is more common, the open myomectomy or the laparoscopic myomectomy?

 

There are two different types of myomectomies: open myomectomy and laparoscopic myomectomy. Dr. Suzanne Slonim tells us which one she thinks is more common.

“I’m fairly certain that the laparoscopic myomectomy is more common. I’m not a gynecologist, I don’t do the procedure, but I think it is laparoscopic.”

 

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What is a myomectomy?

 

While uterine fibroid embolization is a less invasive procedure performed by an interventional radiologist, a myomectomy is performed by a gynecologist and is slightly more invasive. Dr. Suzanne Slonim explains the procedure further.

“A myomectomy is a procedure where the gynecologist usually laparoscopically puts ports into the pelvis, it’s done under general anesthesia, and makes a small incision in the muscle of the uterus, and sort of scoops out the fibroid and takes it out. Now if it’s too big to come out through the port hole, they can do, they can grind it up essentially, and make it small enough to fit out through the port.”

 

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When is a myomectomy better than a Uterine Fibroid Embolization (UFE)?

 

Depending on the size, location, and type of your fibroids, there may be different treatment options that will work best for you. Dr. Suzanne Slonim, M.D., explains when a myomectomy may be the better choice.

“A myomectomy would be preferred if you had a single large fibroid, particularly if it were in the front of the uterus, easy to get to, in front, or side that wasn’t too deep into the tissue, that would be the ideal candidate for a myomectomy.”

See Dr. Linda Hughes’ answer to this question.

 

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What is a myomectomy? What are the challenges with a myomectomy?

 

While Uterine Fibroid Embolization (UFE) is a less invasive procedure performed by an interventional radiologist, a myomectomy is performed by a gynecologist and is slightly more invasive. Dr. Suzanne Slonim, M.D., explains the challenges with undergoing a myomectomy.

“There’s a few challenges, and again, I’m not an OB/GYN, I don’t do the procedure but, the more fibroids you have, the more extensive the surgery has to be and the longer it takes. The position of the fibroids can be very challenging to get to from the laparoscopic approach and the deeper fibroids can be difficult for the gynecologist to get to, and essentially have to go deeper into the uterus.”

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What happens after a Uterine Fibroid Embolization (UFE)?

 

Initially after the UFE procedure it is likely that patients will experience a variety of different side effects. However, a UFE has several long-term effects on the fibroids, namely that your symptoms should diminish and the fibroids should shrink. Dr. Suzanne Slonim, M.D., explains further.

“Okay, so immediately after the procedure you’re going to be uncomfortable, there is going to be pain, there can be low grade fever, nausea, vomiting, just you’re going to feel lousy. I’m going to give you medicines to take care of that discomfort until it’s gone, okay. Now, if you’re talking in a more long-term perspective, then what’s going to happen is the fibroids are going to shrink, the uterus is going to shrink, and your symptoms are going to go away, or improve.”

“It usually takes 3-6 months to see the maximum effect from the procedure”.

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How can fibroids affect sexual intercourse? What changes after a Uterine Fibroid Embolization (UFE)?

 

Fibroids can make sexual intercourse increasingly painful or unappealing, and most women see an improvement after UFE. Dr. Slonim, M.D., explains further.

“Usually they don’t unless there’s an unfortunately positioned fibroid that can cause pain during intercourse. That’s not uncommon actually and I do tell my patients to refrain from having sexual intercourse for two weeks after the procedure, just because there’s going to be inflammation and it’s more likely to be painful, but two weeks will be enough.”

See Dr. Linda Hughes’ answer to this question.

 

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