Uterine Fibroids

Uterine fibroids are the most common tumors of the female reproductive system. Fibroids – also called uterine myomas, leiomyomas or fibromas – are benign growths that develop from smooth muscle cells and fibrous connective tissue either just beneath the outer surface of the uterus, or within the uterine wall. Fibroid growth is linked to the presence of estrogen and progesterone, but the mechanism involved is not understood. Fibroids range from the size of a pea to the size of a grapefruit. As many as 50 percent of women develop uterine fibroids at some point in their lives, but because fibroids may not produce symptoms, many women are unaware that they have them.

Risk Factors and Symptoms

Women in the 30s and 40s are at highest risk of developing fibroids. Women of African-American, Hispanic and Asian heritage also seem to be at an increased risk, for reasons not understood.

Some women with fibroids have mild or no symptoms, while for others symptoms are severe and disruptive. Some women experience iron-deficiency anemia from heavy or prolonged menstrual periods or abnormal bleeding between periods. Common symptoms include:

Heavy or prolonged menstrual periods
Abnormal bleeding between menstrual periods
Pelvic pain (caused as the tumor presses on pelvic organs)
Frequent urination
Low back pain
Pain during intercourse
An enlarged abdomen, which causes a constant feeling of fullness or pressure

Treatments

Most fibroids do not require treatment unless they are causing symptoms. After menopause fibroids shrink and it is unusual for them to cause problems. In those who have symptoms uterine artery embolization and surgical options have similar outcomes with respect to satisfaction.

Symptomatic uterine fibroids can be treated by:

medication to control symptoms
medication aimed at shrinking tumors
ultrasound fibroid destruction
myomectomy or radio frequency ablation
hysterectomy
uterine artery embolization

Hysterectomy - Many women with fibroids are informed by their doctors that they need a hysterectomy, which is a surgical procedure to remove the uterus. Approximately a third to a half of the 600,000 hysterectomies performed each year in the US are for fibroids. For many patients, though, a less invasive uterine sparing alternative called uterine fibroid embolization (UFE) is an option.

Uterine fibroid embolization (UAE) - This is a noninvasive, endovascular procedure effectively treating symptomatic fibroids. Using endovascular techniques, a physician occludes both uterine arteries, thus reducing blood supply to the fibroid.

The physician begins the procedure by inserting a tiny tube called a catheter into an artery at the top of the leg. They guide the catheter into the uterine artery, map the arteries feeding the fibroids with an arteriogram (an x-ray in which a dye is injected into the arteries). A small catheter (1 mm in diameter) is inserted into the uterine artery via the the groin under local anesthesia. Under imaging guidance, the physician will enter selectively into both uterine arteries and inject small (500 µm) particles that will block the blood supply to the fibroids. The fibroids begin to shrink, and many women experience rapid relief from their symptoms. The procedure takes about an hour and the recovery time is significantly less than traditional surgery. Unlike in hysterectomy, the uterus and ovaries are spared.

A patient will usually recover from the procedure within a few days. The UAE procedure should result in limited blood supply to the fibroids which should prevent them from further growth, heavy bleeding and possibly shrink them.

Studies show that most women who undergo UFE experience either significant or complete resolution of their symptoms over time, and fibroids rarely return. This intervention is not usually recommended when fertility should be preserved although subsequent pregnancies are usually possible.

If you would like to see a physician at the University Vascular Associates, please check our physician information and call us for an appointment. Our physicians see patients in offices throughout Southern California. Our office locations and phone numbers are listed below.

To schedule an appointment in the Alhambra office, please call (626) 566-8105. The office address is 1411 S. Garfield Ave. Suite# 303, Alhambra, CA 91801.
To schedule an appointment in the Barstow office, please call (760) 818-0018. The office address is 121 South 7th Ave. Barstow, CA 92311.
To schedule an appointment in the Inglewood office, please call (310) 673-6950. The office address is 575 E. Hardy St. Suite# 322, Inglewood, CA 90301.
To schedule an appointment in the Koreatown office, please call (213) 277-1884. The office address is 515 S. Virgil Ave. Suite# 101, Los Angeles, CA 90020.
To schedule an appointment in the Marina del Rey office, please call (310) 823-7314. The office address is 4560 Admiralty Way, Suite# 356, Marina del Rey, CA 90292.
To schedule an appointment in the Westwood office, please call (310) 209-2011. The office address is 1082 Glendon Ave. Los Angeles, CA 90024.