Fibroid Embolization is offered at both the Voorhees and Marlton Divisions of the Virtua-West Jersey Health System.

Fibroid Embolization. (Also known as Uterine Artery Embolization and Uterine Embolotherapy) is a new alternative treatment for fibroids that helps women avoid the risks, discomforts, and lengthy recovery periods associated with hysterectomy and myomectomy.

What are fibroids?
Uterine fibroids are non-cancerous tumors that develop on or in the uterus, usually originating from a single muscle cell that simply keeps growing. They can be as small as a pea or as large as a grapefruit.

How many women get them?
Fibroids are fairly common, and the tendency to develop them increases with age. They occur in about 30% of women in their thirties, 40% of women in their forties, and 50% of those in their fifties. They can appear at any age, but usually show up during a woman's reproductive years. For some reason, African-American women are three times more likely to develop them, and at younger ages.

Just how serious are they?
Just because they're called "tumors" doesn't mean they're dangerous. In fact, less than 1% of all fibroids ever become cancerous. But they can cause heavy menstrual bleeding, complications during pregnancy, and uncomfortable pressure on the bladder or rectum.

What causes them?
No single cause of fibroids has yet been firmly identified. But because they are most likely to develop when women are in their childbearing years, actually pregnant, or taking oral contraceptives (when estrogen levels are at their peak), there seems to be a definite hormonal link. There is also evidence-such as fibroids running in families-of a genetic predisposition.

What are the symptoms of fibroids?
The most common sign is unusually heavy or prolonged menstrual bleeding, which can also lead to symptoms of anemia.

You should also be alert for:

• Pressure, discomfort, or pain in the pelvis
• Increased menstrual cramps
• Difficult or frequent urination, especially at night
• Constipation and bloating
• Pain in the lower back or abdomen

How are fibroids treated?
Traditionally, there have been two methods of treatment: surgery and hormone therapy.

Surgery can be either a hysterectomy (complete removal of the uterus), or myomectomy (removal of fibroid tissue alone). While hysterectomy can effectively eliminate fibroids, it also involves major surgery, several days of hospitalization, an extended (4-6 weeks) recovery period, as well as loss of the ability to bear children. Myomectomy is less drastic in its effects, but also less certain in its outcome. Symptoms will recur in 20-25% of patients, and additional surgery (usually a hysterectomy) will then be needed.

Hormonal treatment - which uses various compounds and agents to block or lessen the effect of estrogen-can manage fibroids, but generally only on a short-term basis. Extended use can cause osteoporosis, menopausal symptoms, and other complications. Once hormone therapy is discontinued, fibroid growth will resume.

Now there is a new choice. A minimally invasive procedure call fibroid embolization.

How does it work?
Fibroid embolization is performed in the hospital by an interventional radiologist (a radiologist who specializes in minimally invasive surgical procedures).

Although patients are not under general anesthesia and remain awake during embolization, they are sedated to the point that they are not only free of pain, but are often unable to remember details of the procedure. The only thing they feel is the injection of a local anesthetic at the site where the radiologist will make a small, quarter-inch incision to insert a tiny tube called a catheter.

Once inserted, the catheter is guided to the uterine artery and an imaging procedure (angiogram) performed to allow the radiologist to precisely position the catheter within the artery.

When the catheter is in place, tiny pellets are injected and carried by blood flow to the fibroids. The pellets then lodge in the small arteries that feed the fibroids, blocking their blood supply. Starved of blood, the fibroid tissue eventually dies and is eliminated by the body. The entire procedure takes about one hour.

How will I feel afterwards?
While the procedure itself is virtually painless, patients may experience cramp-like abdominal pain immediately after. This is usually managed with medication. Most patients will stay in the hospital overnight, but some may feel well enough to go home the same day. Nearly everyone is able to resume normal activities within a week.

How effective is embolization?
In various studies, from 78% to 94% of all women who have chosen embolization report "significant or total" relief of pain and other symptoms. Nearly all have experienced decreased bleeding and a return of normal menstrual cycles. And, among a group of women whose cases have been followed up for at least six years, no recurrences of fibroids have occurred.

How can I find out more?
If you have any questions about embolization, ask your doctor or contact South Jersey Radiology at 1.888.909.SJRA. Additional information is also available on numerous websites, including that of the Society of Cardiovascular and Intervential Radiology (www.scvir.org).