Physician’s Perspective: Uterine Fibroid Embolization

We spoke with Pete Stratil, MD, to get his perspective on uterine fibroid embolization. This is a procedure he performs regularly at RIA Endovascular.

Why would someone need a uterine fibroid embolization?

Fibroids are benign tumors that grow in the wall of the uterus. While they are noncancerous, fibroids can cause significant symptoms for patients. The primary symptom seen in fibroids is heavy or prolonged menstrual bleeding. Women can also experience bulk symptoms due to the size of the fibroids such as pelvic or abdominal pain or fullness and urinary incontinence. Fibroids can grow as a single tumor, or there can be many of them in the uterus.

Uterine fibroid embolization is used as an alternative to surgery to treat uterine fibroids and minimize their symptoms. Women may choose fibroid embolization over surgery because it is a minimally invasive procedure with a shorter recovery time and minimal risks of complications.

Uterine fibroid embolization is called a minimally invasive procedure because, unlike traditional surgery, we use very small wires and catheters instead of making large incisions. The patient is given moderate, or “twilight,” sedation for the procedure. We thread a catheter through the wrist or groin artery to the arteries supplying the uterus using X-ray guidance. When the catheter reaches the uterine artery, tiny beads are injected, and they lodge in the fibroids and cut off the blood supply to the fibroid.

Decreasing the blood flow to the fibroid results in a dramatic improvement in bleeding symptoms and also causes the fibroid to shrink over time, which can also decrease the bulk symptoms mentioned above.

What value do you find in performing this procedure (why do you like performing this procedure?)?

Most of the patients who come to see us for a fibroid embolization have been very uncomfortable for a while. They often have been apprehensive about a surgical option, such as a hysterectomy, because of the complications they may run into postop. Uterine fibroid embolization results in a 90% to 95% improvement in bleeding symptoms and an 85% improvement in bulk symptoms, and the procedure is done in a minimally invasive way, so there is less downtime and pain. I really enjoy hearing from my patients at their follow-up visits. I have had women express that this was the best decision they could have made when it comes to their physical and mental health.