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1. What are typical symptoms of fibroids?
- Heavy, prolonged
menstrual periods sometimes with clots. The bleeding could lead to
anemia.
- Pelvic pain,
pressure or heaviness caused by bulk or weight of the fibroids
- Pain in back or
legs due to pressure on nerves
- Pain during sexual
intercourse
- Urinary
frequency
- Constipation
- Bloating
2. Who is most likely to have fibroids?
Twenty to forty percent of women age 35 and older have fibroids of
significant size. While fibroids can affect women of any race, African
American women are at higher risk. Approximately 50% of African
American women will have fibroids and these fibroids tend to be
heavier, bulkier and hence more symptomatic than fibroids in the
remainder of the population.
3. How are fibroids diagnosed?
Typically, the diagnosis is made by gynecologic pelvic exam. If the
uterus feels enlarged, then the presence of fibroids can be confirmed
with a pelvic ultrasound. Diagnostic hysteroscopy is also an option
that can be performed in the office by your gynecologist. In this exam,
a long, thin probe-like instrument called a hysteroscope is passed
through the vagina, cervix and then into the uterus. The gynecologist
can then check for growths such as submucosal fibroids. An endometrial
biopsy can be obtained at that time. Fibroids can also be diagnosed
with a MRI or CT scan.
4. Who is a candidate for UFE?
The ideal candidate is a pre-menopausal woman with symptomatic
fibroids who does not desire future fertility. Most women with
symptomatic fibroids are candidates for UFE. However, you should have a
consultation with one of our interventional radiologist to be sure that
UFE is the best treatment option for you.
5. How effective is UFE for treatment of fibroid symptoms?
On average, 90% of women who have had the UFE procedure experience
significant or total relief of heavy bleeding. The procedure is about
85% effective for pelvic pain. The procedure is effective for multiple
fibroids. Short and mid- term data show the UFE procedure to be very
effective with a low rate of recurrence. Long-term (10-year) data is
ongoing and not yet available. However, in one study in which patients
were followed for six years, no fibroid that had been successfully
embolized regrew.
6. How soon after UFE should I see improvement in my
symptoms?
Some patients experience relief of symptoms right away. However, the
vast majority of patients will experience relief of symptoms after 2-3
menstrual cycles. A small minority of women will require 4-5 menstrual
cycles before they appreciate significant improvement in symptoms after
the UFE procedure.
7. Will my fibroids completely disappear after my UFE
procedure? Will my fibroids grow back?
No. Your fibroids will not completely disappear following UFE. Your fibroids
will only shrink. The average amount of fibroid shrinkage ranges from
40–50%. The overall uterine volume will diminish by 30-40%. This amount
of shrinkage has been shown to be very effective in treating the
symptoms of heavy bleeding, pressure and pain. Fibroid shrinkage takes
place over a 6 to 9 month time frame. With approximately 6 years of
follow-up now available, it is clear that successfully treated fibroids
will not regrow. However, it is not known whether patients will develop
new fibroids.
8. Is UFE a safe procedure?
When compared to myomectomy and hysterectomy, UFE is extremely safe.
Myomectomy and hysterectomy are major surgical procedures requiring
general anesthesia, which alone carries significant risks not to
mention the risks of the surgery. The UFE procedure is safer in that
general anesthesia is avoided. UFE procedures are very well tolerated
only using conscious IV sedation and a local anesthetic. The UFE
procedure does however carry some risks which have been discussed
earlier. Significant complications resulting from UFE occur in far less
than 1% of patients.
9. Are the embolic particles used in the UFE procedure safe?
The embolic particles most commonly used in UFE have been available
with FDA approval for use in patients for more than 20 years. During
that time, they have been used in thousands of patients without
long-term complications.
10. Is UFE a painful procedure?
Most patients experience little or no pain during the procedure.
However, at the end of the procedure when the blood flow to the
fibroids has been cut-off, patients will start to develop pain and
cramping that will likely get worse over the next 6 hours. You will
spend the night in the hospital and this pain will be treated with
narcotic medications. The next morning, the pain will be significantly
less and you will be able to go home with prescriptions for less potent
pain medications.
11. What should I expect with regard to follow-up after my
UFE procedure?
We will notify your gynecologist that you have had the UFE
procedure. We will follow you by telephone the first week after your
UFE procedure to make sure your recovery goes smoothly. We recommend
you make an appointment to see your gynecologist at 6- 8 weeks after
your UFE procedure. A pelvic US can be performed at 3 months, but we
now recommend a pelvic MRI exam be performed at 6 months. To ensure
reliability and consistency of the results, this pelvic MRI exam should
be performed at one of the Decal Medical facilities.
12. How does the UFE procedure affect fertility?
The vast majority of patients choosing UFE are not interested in
future pregnancy. Therefore, the long-term effects of UFE on pregnancy are
still unknown. However, there are studies currently underway specifically
to answer this question. It should be noted that there have been
numerous reports of normal pregnancies following UFE. We have treated
more than a few patients desiring future fertility who were deemed poor
candidates for myomectomy. At this time, there is insufficient
information to predict what percentage of women will be able to become
pregnant after UFE.
13. How long after the UFE procedure should I wait before
trying to become pregnant?
Unfortunately, there is little or no clinical data currently
available to make that determination. Based on theory, we recommend
that our UFE patients wait approximately 12 months before trying to get
pregnant. This should allow ample time for the uterus to heal and any
transient amenorrhea to resolve.
14. I have had a previous myomectomy, am I still a candidate
for the UFE procedure?
Yes. We have successfully treated many women for whom myomectomy and
hormonal therapy have failed. In fact, the majority of our UFE patients
have come or have been referred to us precisely because other
treatments have failed and they do not want to have a hysterectomy.
15. What if I do not have a gynecologist?
We strongly recommend that any patient considering UFE be initially
evaluated by a gynecologist. There are a number of gynecologists on
staff at Dekalb Medical who are very familiar with the UFE procedure
and very willing to provide excellent follow-up care to patients who
decide to undergo the UFE procedure. We will be happy to discuss this
further at the time of your consultation.
16. I have lost or no longer have health insurance, can I
still have the UFE procedure?
Yes. Other payment arrangements can be made. For more details, please
contact Margie Maxey, Practice Administrator for Radiology Associates
of DeKalb, P.C. at 404 564-5400 x15.
17. How do I schedule a consult?
To schedule a UFE consult with one of our doctors, please call 404
501-2660. UFE consultations are performed daily at DMC Central Campus.
We now charge a fee for this consultation that is usually covered by
your insurance.
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