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Less invasive procedure provides alternative to hysterectomy for women suffering with fibroid tumors
Topics: uterine fibroids, women, health, uterine fibroid embolization, hysterectomy
Posted by LisaW Wed Aug 8, 2007 15:50:11 PDT
Viewed 920 times
0 responses 0 comments Lorie Stites went about two years of her life much like any other woman.

Little did she know that a fibroid tumor was slowly growing inside of her.

In fact, Stites didn't experience symptoms for about two years. That’s when she began bleeding more frequently than her monthly cycles.

"Then the fibroid grew to its maximum size of 7 centimeters and it began pushing on my bladder so I couldn't hold my bladder," said Stites, 45.

Stites' gynecologist put her on birth control, which helped with the bleeding and controlled some of the growth. However, she was still having bladder problems.

She couldn't drink anything, had to stay close to a bathroom at all times and often woke up several times in the night to go to the bathroom. Stites also developed anemia as a result of the frequent and heavy bleeding.

The last straw was when she bled for a month and a half straight.

Uterine fibroids are common, benign and noncancerous tumors that grow on or within the muscle tissue of the uterus. Fibroids occur more frequently in minorities than in caucasians.

It is estimated that nearly 70 percent to 80 percent of all women have fibroids. Some women have them for years and experience no symptoms.

Others are not so lucky.

Like Stites, nearly 25 percent of all women have symptoms from fibroids that are impossible to ignore.

Fibroids can cause heavy menstrual bleeding, pelvic discomfort, a bloated abdomen, anemia, painful intercourse, leg pain and create pressure on other organs as they grow from the size of a walnut to that of a cantaloupe or larger.

Stites went to her gynecologist again and was given the choice between a hysterectomy and a procedure known as uterine fibroid embolization (UFE).

Many women are not given this choice.

In a 2002 study of UFE patients at Chicago's Northwestern Memorial Hospital, 79 percent had learned about the procedure by a source other than a gynecologist.

It may be that money talks when it comes to this procedure.

"OB/GYN’s want to do hysterectomies. If they refer the patient out for UFE, then they don't get to do the hysterectomy... There is a certain amount of turf war, physicians do compete," said Dr. Arthur Fontaine, an interventional radiologist at Mercy Hospitals of Bakersfield.

Interventional radiologists perform UFE procedures, while gynecologists perform hysterectomies.

Hysterectomies are expensive, with gynecologists receiving about $2,000 for the procedure. There are nearly 200,000 hysterectomies performed each year in the United States for fibroids, meaning that $400 million in annual fees are at stake.

Hysterectomy is a major surgery. Even though it has low complication rates, those complications are major.

"It's major surgery, so there are all the complications associated with going under general anesthesia, but it's more than that. You would not believe the cases I've seen and heard about where something gets accidentally nicked or clamped off, abscesses, obstructed ureter — the tubes that transport urine from the kidney to the bladder," Fontaine said.

Research also shows that the procedure can cause depression, sexual dysfunction, weight gain, high blood pressure and premature menopause.

"I didn't want a hysterectomy because there are a lot of complications with major surgery," Stites said. "You can lose nerve endings and bladder control, not to mention infection."

UFE, on the other hand, is a minimally invasive procedure. One major plus is that women who undergo UFE get to keep their uterus, which can hold emotional attachment for some women.

A small catheter is inserted through a tiny incision in the upper thigh and threaded through an artery to the blood vessels near the fibroids. Tiny particles (emboli) are injected into branches of the uterine artery that carry blood to the fibroid. The fibroid shrinks when the blood supply is cut off.

Stites did weigh the risks of UFE in her decision making as well, she said.

"There was a risk of still losing my uterus because it could just block it up so much and there was also a risk of throwing me into pre-menopause," she said.

Recovery times for both procedures are also significantly different. UFE patients can generally return to their normal activities in about seven to 10 days, while hysterectomy patients require a four- to six-week recovery period.

Weighing both her options, Stites elected to have the less invasive UFE procedure over major surgery in January 2006.

"Since the surgery, I've had no complications. My previous symptoms were almost immediately gone after the surgery," she said. "And the best part is that I don’t have to go to the bathroom during the night and I'm not anemic anymore."

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Uterine fibroid facts
• Uterine fibroids are common, benign and noncancerous tumors that grow on or within the muscle tissue of the uterus.
• Fibroids may cause heavy bleeding, pelvic discomfort, bloated abdomen, anemia, painful intercourse, leg pain or create pressure on other organs.
• Fibroids are typically diagnosed through pelvic exams or ultrasound by a gynecologist and can grow as small as a walnut or as large as a cantaloupe or bigger.
• Up to 70 percent to 80 percent of all American women have uterine fibroids.
• Approximately 6 million American women with fibroids have symptoms severe enough to require medical treatment.
• Up to one-third of women with fibroids experience symptoms that can become so severe and debilitating that their everyday life is affected.
• Symptomatic uterine fibroids are typically diagnosed in women between the ages 35 and 54.
• Uterine fibroids can and do occur in women under the age of 35 and even as young as the early 20s.
• Fibroids are more common in minorities than caucasians.
• Two-thirds of the 600,000 hysterectomies performed each year in the U.S. are for treating uterine fibroid tumors.
• More than one-third of employed women miss at least one day and about half miss more than two to three days of work a month due to their fibroid symptoms

—Source: BioSphere Medical

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