Fibroid Treatments: Read Wendy's Story
Many tumors begin their lifespan in our bodies as a perfectly harmless, non-cancerous mass. Sometimes we can live with them our whole lives and not even know.
For some, simply because the tumor isn’t cancerous, does not mean it isn’t causing problems. This is the case for many women living with uterine fibroids.
What are Uterine Fibroids?
Uterine fibroids are benign (non-cancerous) tumors of the muscle tissue in the uterus. Although little is known about uterine fibroids and how to prevent them, studies have found that nearly 40 percent of women — and as many as 50 percent of African American women — over the age of 35 have uterine fibroids of significant size.
The location, size and presentation of uterine fibroids varies from ones that are in the cavity of the uterus (submucosal) to those on the outside surface of the uterus (subserosal). They range in size from pea-sized to ones as large as a football.
Symptoms that may be associated with uterine fibroids include:
- Heavy bleeding (menorrhagia)
- Painful periods (dysmenorrhea)
- Pain in the lower abdomen
- Pain during sexual intercourse (dyspareunia)
- Urinary frequency or leakage
- Constipation or pain during bowel movement
How are Fibroids Diagnosed?
A pelvic examination by an obstetrician/gynecologist is the first step in diagnosing uterine fibroids. Other studies, such as a pelvic ultrasound, a CT scan, and/or MRI of the pelvis may be used in helping to identify the location, size and number of fibroids in the uterus.
Depending on the tumor’s location, there are a variety of treatment approaches. Medications may be successful in both controlling and sometimes treating the symptoms including the heavy and irregular bleeding and painful periods. Patients may also receive either surgical or non-surgical treatment.
The Surgical Approach
The most common surgical procedures associated with this condition are myomectomy and hysterectomy. In the myomectomy surgery, the fibroids are removed, leaving the uterus intact. This procedure is a good option for women who are considering pregnancy. Hysterectomy, or the surgical removal of the uterus, is the only treatment that offers a permanent solution to symptoms. However, because the uterus is removed, women who have had a hysterectomy will no longer have the option to bear a child.
Both surgeries can be completed either via open surgery or a minimally-invasive surgery (laparoscopic approach), depending on the size and location of the fibroids. Recovery from an open surgery may take two to three weeks, while recovery from minimally-invasive surgery is two to three days. Both these techniques are performed by gynecologists from RWJ OB/GYN .
When medical intervention is not effective and the patient wishes to avoid surgery, she may choose uterine fibroid embolization (UFE), a treatment offered by an interventional radiologist and conducted at RWJ Hamilton for several years.
In the UFE procedure, small round particles called embospheres are injected into the arteries that feed the uterus and fibroids. These particles cut off the blood supply to the fibroids, causing the tumors to shrink.
“Uterine fibroid embolization is a highly effective, minimally-invasive way to treat fibroids without surgery,” says Aaron Shiloh, MD, board certified in radiology and interventional radiology.
“Fibroids will not disappear, but they will shrink significantly. In the course of one year after UFE treatment, fibroids will typically shrink by about 60 percent and heavy bleeding is decreased in more than 90 percent of cases,” explains Shiloh.
“Patients usually stay overnight in the hospital and are released the next day,” says Shiloh. The overall recovery time from UFE is a week to 10 days. “I often hear from my patients that they are experiencing a complete resolution of their symptoms, and they are more comfortable simply leaving the house. One of the most rewarding things for me personally is hearing from a patient who has had a dramatic improvement after treatment.”
Wendy's uterine fibroids were a burden on her quality of life. Having had several unsuccessful treatments including freezing the fibroids, heat ablation and a D&C (dilation & curettage), Wendy sought the help of Aaron Shiloh, MD.
Much to her surprise, Dr. Shiloh diagnosed Wendy with adenomyosis, a condition characterized by uterine thickening that occurs when endometrial tissue -- which normally lines the uterus -- moves into the outer muscular walls of the uterus.
"I thought I had a few fibroids, but it turned out I had dozens of them," says Wendy. "Dr. Shiloh said to me, 'You have two choices. You can have a hysterectomy or a procedure called uterine fibroid embolization.'"
Wendy discussed these options with her husband as well as her sister and brother-in-law, who are both physicians. Her husband advised that she should exhaust her options before considering a hysterectomy.
Unlike the recovery associated with a hysterectomy, Wendy only experienced an overnight hospital stay and minor aches the next day.
Wendy recommends women troubled by fibroids look into uterine fibroid embolization. "Investigate UFE, for me it was a god-send."