Fibroid treatment without surgery

Fibroids are non-cancerous growths of the muscle of the uterus during reproductive years.

One in five women has fibroids and black women are two to three times more likely to have them than Caucasian women. Depending on the size, location and symptoms, different treatment options are available.

Uterine fibroid embolisation is a non-surgical alternative for patients who want to avoid open surgery, or have risks of surgical complications, a history of keloids (overgrowth of scar tissue), blood clots, or medical conditions that may complicate anaesthesia.

The procedure is carried out in a catheter laboratory. Patients are admitted before treatment, spend a night in the ward after the procedure and are discharged the following morning.

After a full gynaecological review and discussion of treatment options, magnetic resonance imaging (MRI) and ultrasound scans are conducted before the process to define the structure of the fibroid and assess the likely response to treatment.

PAINLESS

Uterine fibroid embolisation is a painless operation and therefore a full anaesthetic is unnecessary. After a sedative and a local anaesthetic, a tiny nick in the skin is made to allow a very fine catheter to be passed into a blood vessel.

The catheter tip is moved along the blood vessels until the uterine arteries are reached. A substance is then injected to block the uterine arteries. All this is followed on an x-ray screen by a radiologist.

Following the procedure, the patient rests in the ward overnight. Some painkillers are usually needed for the night in hospital, followed by tablets for two to seven days after being discharged.

It is possible to resume normal activity and return to work two weeks after the procedure.

Uterine fibroid embolisation reduces menstrual blood loss in those with anaemia. In addition, it allows for rapid resumption of normal activity and is used as a means of shrinking fibroids to reduce pressure symptoms.

Patients are advised to wait for six months before attempting to conceive. There may be some increase of risk to the pregnancy in the presence of fibroids, so plans for future childbearing should be carefully discussed with a doctor before planning treatment.

Dr Obura is a consultant hysteroscopic and laparoscopic surgeon and vice chair of the Department of Obstetrics and Gynaecology at Aga Khan University Hospital