Category: Treatment Options

3 Reasons to Choose UFE Over Surgery

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When you have uterine fibroids, it’s important to explore all your treatment options. Many women with fibroids are told they need a hysterectomy (surgical removal of the uterus), but they could still find relief with myomectomy (surgical removal of the tumor) or uterine fibroid embolization (a minimally invasive treatment protocol that blocks blood flow to your fibroids, causing them to shrink.) 

While hysterectomy is a drastic surgery, some women may be confused abut which of the two less invasive treament options would be their best choice. Now, new research is giving women two important reasons to choose UFE. 

3 Main Advantages of Uterine Fibroid Embolization 

According to research conducted by Dr. Jemianne Bautista-Jia, UFE may be more effective than myomectomy at relieving fibroid symptoms. The study discovered these three advantages: 

  1. Women with UFE were less likely to need secondary procedures than women who had myomectomy
  2. Women were less likely to need a blood transfusion after UFE than following surgery
  3. Women whose fibroids caused heavy menstrual bleeding experienced better relief with UFE than with myomectomy

While the study did note that more women became pregnant after myomectomy than after UFE, all other findings pointed women towards greater relief with UFE. Dr. Bautista-Jia, in presenting the findings wanted women with fibroids to take away his message: if heavy bleeding is your main fibroid symptom, UFE is the way to go. She also suggested that all women with symptomatic fibroids should explore UFE as a great treatment option. 

Want more info on UFE? Reach out and schedule a consultation with our Houston area fibroid specialists. 

Sources: evtoday.com, Society of Interventional Radiology

#WCW: Raquel K Finds an Alternative to Fibroid Surgery

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Many times, we feature celebrity fibroid warriors as our Woman Crush Wednesday, but this week we get to draw from our own patient pool. A few months ago, we welcomed Raquel K. to our Houston area fibroid practice; as she explains, she came to us because she was, “looking for an alternative to having surgery due to fibroids.”

Like many African American women, Raquel was diagnosed with fibroids and was facing scary treatment options like surgical removal of her tumors or even of her uterus (hysterectomy.) When she discovered our practice and scheduled her first appointment, she says, “Dr. Fox and his team took time to explain the UFE procedure and made me feel very comfortable.” UFE (Uterine Fibroid Embolization) is an alternative treatment for fibroids that is minimally invasive and is performed as an out-patient procedure. Our doctors insert a catheter through our patient’s femoral artery, in your upper thigh. Next, we guide the catheter to the uterine artery until we get close to your fibroid tumor. Finally, we inject an embolic substance into the catheter. The embolic material is designed to block the vessels around the fibroid, depriving it of the blood and oxygen it needs to grow. The blood and oxygen deprivation results in the shrinking of your fibroids, and the embolic material remains permanently in the blood vessels at the fibroid site. 

After Raquel successfully underwent her UFE procedure, she turned to our practice Facebook page to share her story, helping other patients learn about UFE. In telling her fellow fibroid patients, “My quality of life has improved greatly since my UFE and I am very happy with my results,” she’s helping spread the word about this alternative #FibroidFix. And, in our well-versed hashtag books, that earns her a spot on the #WCW list, as well! 

Study Proves that UFE is as effective as Fibroid Surgery

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At the recent 2019 convention for the Society of Interventional Radiologists, we got some exciting news: UFE is just as effective a treatment for fibroids as myomectomy surgery!

Uterine fibroids are muscular tumors that develop in the wall of the uterus; they’re typically non-cancerous, and may sometimes go unnoticed by the women in whom they have developed. Symptomatic women may experience heavy menstrual bleeding, frequent urination and pain during sex, among other complications. Fibroids can also make it more difficult for women to become or remain pregnant. 

Many women are told that a hysterectomy (surgical removal of the uterus) is the answer to troubling fibroid symptoms. But women who don’t want to have a hysterectomy have to choose between other treatment options, including Uterine Fibroid Embolization and Myomectomy. UFE involves threading a thin tube into the blood vessel that supplies a fibroid tumor. Then, small plastic or gel particles are injected into the blood vessel to block it permanently, which causes the fibroid to shrink over time. Myomectomy, in contrast, involves surgical removal of a fibroid tumor; it is considered a more invasive treatment plan but may be a better option for women who want to become pregnant after fibroids. 

New Study on Fibroid Treatment Options

In this new study, researchers looked at data from 950 women, half of whom had UFE and half who had a myomectomy to treat fibroids. The women were followed for an average of seven years after their procedures.

After reviewing the data, the findings were pretty clear: the procedures appeared to be similarly effective at treating fibroids. And, among the women who had a myomectomy, there were higher rates of post-surgical complications, including the need for a blood transfusion (2.9 percent from the myomectomy group versus 1.1 for those who had UFE). 

Study author Dr. Jemianne Bautista-Jia said, “The two treatments were comparably effective [and] UFE resulted in more favorable outcomes.” Additionally, the radiology resident at Kaiser Permanente Los Angeles Medical Center noted, that there was less pain and shorter recovery times for the women who had UFE. Those women also reported a greater improvement in relief from heavy bleeding.

In spite of all these benefits, she noted that, “patients are often not fully informed of their treatment options.” She hopes these study findings will help raise UFE awareness. She encourages all women with fibroids to discuss UFE with their doctors before deciding on a course of treatment. 

What Makes Fibroid Morecellators So Dangerous?

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When a woman has uterine fibroids, she may be advised to have surgery: either a hysterectomy (removal of the uterus) or myomectomy (removal of the fibroid). During a laparoscopic surgery, doctors once thought it was ok to use a power morcellator, a tool that help surgeons divide and break up tissue into smaller pieces. This helped doctors easily remove your fibroid tissue through a small surgical incision.

Dangers of morcellation during myomectomyWhile this idea is good in theory, we now know that this tool has been found to spread cancer cells throughout your body. In fact, the FDA has warned against the use of power morcellators.

Why is Morcellation Dangerous?

When women undergo either a hysterectomy or myomectomy, they may also have malignant uterine sarcoma, an aggressive type of cancer that is fatal once it spreads. Because of the rapidly spinning blades on the power morcellator, malignant cells can be spread to other areas inside the abdomen.

Previous data suggested that 1 in every 10,000 women who undergo myomectomy or hysterectomy has an undiagnosed uterine sarcoma, but newer findings suggest that number is actually closer to 1 in 350. This discovery makes morcellation even more dangerous than originally thought.

Is There a Way to Make Morcellation Safer?

While some surgeons suggest that the use of containment bags will help minimize the unwanted spread of tissue, this method isn’t completely safe–after all, these bags can break! 

Because of all the potential risks, there is currently no way to make morcellation safe. It is nearly impossible to diagnose a sarcoma that is hidden by a fibroid tumor, so it is far safer for surgeons to avoid performing this procedure.

Uterine Fibroid Embolization: A Non-Surgical Option

Uterine Fibroid Embolization (UFE) is performed by an interventional radiologist and blocks blood flow to the uterine fibroids, thus causing the tumors to shrink. No incisions are needed and the uterus remains completely intact. Patients leave the office without sutures and are able to go home the same day. And, because no surgery is necessary, there is no risk of spreading dangerous cancer cells to other parts of your body! 

To learn more about UFE, schedule a consultation with Houston Fibroids.

New Health Warning About Popular Fibroid Drug

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Health Canada has released a new health warning about Allergan’s uterine fibroid medication, Esmya (also known as Fibristal.) According to the warning, the medication can cause a rare but serious liver injury. 

Uterine fibroids are non-cancerous tumors that develop inside, on or in between the layers of a woman’s uterus. Esmya is an oral medication intended to manage some fibroid symptoms, particularly heavy bleeding during your period. Prior to this warning, Esmya was prescribed for women who were of child-bearing age and didn’t want to undergo surgery, or for women who were awaiting surgery and wanted to mitigate their symptoms. While the drug has been widely prescribed in Canada and Europe, the FDA here in the U.S. has declined approval of the drug for use in this country. 

Because of the newly-discovered potential for liver injury, doctors are  being told to change the ways in which they use the medication. Now, it’s only recommended for women who want to have children. Even for these women, doctors should only prescribe one course of the drug–refills aren’t recommended. And, of course, no woman with a history of liver problems should ever take the medication. 

Other Alternatives to Fibroid Surgery

It’s not surprising that many women want to avoid fibroid surgery. Whether opting for a myomectomy (surgical removal of the tumor) or a hysterectomy (removal of the entire uterus), surgery is a big deal. It typically comes with a hospital stay and a considerable recovery time. 

Given the potential for serious complications, however, medication shouldn’t necessarily be the solution for young women dealing with fibroid symptoms. In our Houston area office, we provide a minimally-invasive fibroid treatment with no down time and outpatient delivery. While it is not right for everyone, it is certainly a treatment option worth considering, since it offers a non-medicinal, non-surgical solution for fibroid sufferers. If you’re currently investigating fibroid treatment options, be sure to schedule a consultation with Dr. Fox or Dr. Hardee to learn whether Uterine Fibroid Embolization is the right option for you.  

UFE Gives Better Fibroid Outcomes, Study Proves

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According to a new Mayo Clinic study, minimally invasive uterine fibroid treatments offer better results than surgical options. According to findings published in the American Journal of Obstetrics and Gynecology, women who treated fibroids with UAE (uterine artery embolization) were less likely to need a second procedure than women who were treated with MRI focused ultrasound surgery (MRgFUS). 

The study found that, both treatments reduced women’s fibroid treatments, but UFE offered a greater symptom reduction.

Of course, the study proved that both procedures were minimally invasive, making them viable alternatives to hysterectomy (the complete removal of a woman’s uterus.) This is great news for all women, since fibroids lead to about 200,000 hysterectomies each year in this country.  While hysterectomies can “cure” women of fibroids, removing a woman’s uterus has been shown to increase a woman’s risk of long term health complications, including weight gain and heart disease.

What’s important about this new study is that, finally, alternatives to hysterectomies are being compared to one another to see which is the best option. And in this study, called FIRSTT Fibroid Interventions: Reducing Symptoms Today and Tomorrow, Mayo Clinic, Duke University and University of California, San Francisco,  researchers compared MRgFUS to UAE to determine effectiveness.

During the study, 83 participants were randomly assigned to receive one of the two treatments: UAE or MRgFUS. Over the next four years, researchers compared the outcomes of the two procedures in 70 women who underwent MRgFUS and 62 who were treated by UAE. Of the MRgFUS women, 30 percent underwent a second fibroid procedure; only 13 percent of the women who were treated with UAE needed a second procedure.

For interventional radiologists like Dr. Fox and Dr. Hardee, this study is heartening. What it proves to us, and to our patients, is the fact that not only are alternative hysterectomy treatments effective, some are more effective than others. It emphasizes the importance of considering all your options before deciding how to deal with your fibroid diagnosis.

How Fibroids Can Affect Your Fertility

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Those non-cancerous tumors made up of cells and muscle known as fibroids can be a quirky lot. Many women with uterine fibroids have no symptoms whatsoever, and some never even know they have them. Others have painful and heavy periods and struggle with discomfort. With all these disparate situations you may be wondering if and how fibroids can affect your fertility.

Continue reading “How Fibroids Can Affect Your Fertility” →

Adenomyosis: What You need to Know

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Adenomyosis is a condition that causes many symptoms—like pelvic pain and heavy bleeding—that mimic fibroid symptoms. This condition is the result of endometrial cells (from the uterine inner lining) that migrate into the middle, muscular wall of the uterus, the myometrium, where they stay put. The newly lodged cells then increase the mass of your uterus. 

What Causes Adenomyosis?

Unfortunately, we still don’t understand the exact cause of this condition, although different the

pain from uterine fibroids

ories exist. One suggests that it’s caused by genetic changes in endometrial cells. Another proposes that, in fact, cells inside your myometrium actually convert into endometrial cells. We also believe that hormones like estrogen trigger the condition since its symptoms go away after menopause. Female levels of estrogen go down in the first year after menopause and the symptoms dissipate as well.

How is Adenomyosis Diagnosed?

This condition is sometimes diagnosed with an ultrasound scan, but it can be difficult to spot lodged cells, so an MRI is often needed for confirmation. Often, adenomyosis is detected while your doctor is screening for fibroid tumors.   

What Are the Symptoms of Adenomyosis?

While a good portion of women—as many as 30%–won’t experience any symptoms, women with adenomyosis typically experience:

  • Heavy bleeding
  • Intense pelvic pain and pressure
  • Cramping
  • Pain that radiates to your legs and back
  • Distended stomach
  • Blood clots in the pelvis and legs
  • Prolonged menstrual cycles
  • Spotting between cycles
     

How is Adenomyosis treated?

The only way to cure this condition is to undergo a hysterectomy. For many women, this will be too drastic an option—especially since we now know that hysterectomies leave women at risk for cardiac and metabolic problems.

So, while we can’t stop the problem without removing your uterus, we can help manage symptoms with less invasive treatment options. The best option for you will depend on the severity of your symptoms and your overall health:

  1. Anti-inflammatory medications like ibuprofen can help with the pain and reduce the blood flow. For best results, start taking medication several days prior to the start of your cycle.
  2. Taking birth control pills and other hormonal supplements can help manage the condition.
  3. Endometrial Ablation is a minimally invasive procedure that destroys the uterine lining, so no cells can migrate into the muscle wall. The success of this option will depend on how deeply endometrial tissue has penetrated into the wall of your uterus.
  4. UAE or Uterine Artery Embolization is a technique commonly used to treat uterine fibroids. When treating adenomyosis, particles are injected into the uterine artery to block the blood flow to the specific problem area. The goal is to deprive the tissue of both blood and oxygen so the condition will abate. Unlike UFE for fibroid treatments, UAE for adenomyosis involves an overnight stay in the hospital. As we evolve our technique, UAE has earned an 80% effectiveness rating in abating the symptoms of adenomyosis, making it an excellent short term solution to this painful condition. 

 

Warning: Hysterectomies Lead to Long Term Health Issues

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Many women believe that undergoing a hysterectomy (the surgical removal of the uterus) will cure their fibroid problems. And while that may be true, a new study from the Mayo Clinic says that, in doing so, women set themselves up for more serious problems down the road. 

In fact, according to the study, women who undergo hysterectomies–even if their ovaries are preserved–have a big increase in their risk of many metabolic and cardiovascular conditions. Dr. Shannon Laughlin-Tommaso, who authored the study, says, “This is the best data to date that shows women undergoing hysterectomy have a risk of long term disease…while women are increasingly aware that removing their ovaries poses health risks, this study suggests hysterectomy alone has risks, especially for women who undergo hysterectomy prior to age 35.” 

To reach these conclusions, researchers followed 2094 women who’d undergone hysterectomies, with ovary preservation, between 1980 and 2002. Each of these women was then compared to a woman her same age, in her same county of residence, who had not undergone a hysterectomy. What they found was frightening: the women who’d had hysterectomies were 14% more likely to have lipid abnormalities, 18% more likely to be obese, 13% more likely to have high blood pressure, and had a 33% increase in risk of coronary artery disease. These risks increased in the women who’d had their hysterectomies before the age of 35. 

For years, hysterectomy was thought of as the best way to treat fibroid tumors. Many women are still told that this is the right treatment choice, even though other, less invasive, options are now available. In the light of this research, however, the reasons for seeking alternative fibroid treatments is abundantly clear.

As Dr. Laughlin-Tommaso says, “Hysterectomy is the second most common gynecologic surgery, and most are done for benign reasons, because most physicians believe that this surgery has minimal long-term risks. With the results of this study, we encourage people to consider nonsurgical alternative therapies fro fibroids, endometriosis and prolapse, which are the leading causes of hysterectomy.”

Birth Control and Fibroids: What You Need to Know

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Uterine fibroids are non-cancerous tumors that affect many women throughout their lifetime.  Fibroids can develop in several different places in or on the uterus, and will be classified as  as subserosal, intramural, or submucosal depending on where they develop. While no one knows exactly why these tumors develop, most doctors agree that their growth can be affected by the presence of estrogen, which may be why many women’s fibroids grow and develop during pregnancy. Because estrogen likely affects fibroid development, many women will wonder how taking birth control will impact their fibroid growth and development. Here are four things women with fibroids should know about their birth control:

Your Periods Will Probably get Lighter

A common side effect of fibroids is long, heavy periods; using birth control pills may help manage this symptom. Birth control typically gives women lighter, shorter periods because the estrogen in the medications can help improve blood clotting and reduce your menstrual flow.

You May Have Fewer Cramps

Pelvic pain and cramps are another typical fibroid side effect—and these cramps can be quite severe for women dealing with these tumors. Many women on birth control pills experience cramping relief because the medications can decrease a woman’s prostaglandin count (prostaglandins make the uterus contract, leading to cramps.)

Your Fibroids Could Get Bigger

While taking birth control may help you manage certain side effects of fibroids, there’s a caveat: fibroids are very responsive to estrogen, which means that taking birth control can actually make your tumors grow larger. For this reason, you’ll need to discuss your options with your doctors carefully. A larger fibroid tumor may cause you to experience a worsening of symptoms, canceling out the temporary relief delivered by the estrogen in your birth control pills.

Birth Control Can Help Prevent Fibroids

If you already have uterine fibroids, taking birth control could make your tumors increase in size. But if you haven’t yet been diagnosed, certain birth controls (especially those with lower doses of estrogen) may reduce your fibroid risk!

Choosing the right birth control when you have fibroids can be complicated, so it’s crucial to review all your options with your fibroid specialist. Feel free to reach out to Dr. Fox or Dr. Hardee to schedule a consultation on all your fibroid treatment options.