- April 1, 2020
- Posted by: cmcdonald
- Category: Uterine Fibroid Embolization (UFE)
Dr. Chris Donikyan, a leading authority on endovascular care, practices in our Fishkill, New York, location. In this interview, he answers questions about uterine fibroids and explains the difference between Uterine Fibroid Embolization (UFE) and hysterectomy.
Q: What are the most common symptoms of uterine fibroids?
A: One of the most common symptoms of fibroids is a feeling of fullness or pressure in your pelvis, which may become worse during your menstrual cycle. As fibroids get bigger, they occupy more space in the uterus and can cause pressure on adjacent parts of the body. For example, because the bladder is right next to the uterus, fibroids can cause urinary difficulty including an increase in frequency and urgency. In addition, fibroids can cause heavier than normal bleeding during the cycle or bleeding in-between cycles which can lead to anemia.
Q: How are uterine fibroids diagnosed?
A: Generally when a woman has issues with excessive bleeding, pain, or discomfort, the first step is an ultrasound. Because fibroids appear in the uterine tissue, an ultrasound is the easiest, quickest, and least invasive way to make a diagnosis. For more difficult cases, an MRI may also be used.
Q: Are there any foods or diets you recommend for women with uterine fibroids?
A: A diet high in fiber and potassium can help slow the growth of fibroids and potentially shrink them. Foods that are rich in fiber include fruits and vegetables. Foods that are high in potassium include bananas and avocados.
Foods to avoid include red meats and pork as they tend to release estrogen which helps fibroids grow. By avoiding red meat and pork you can decrease estrogen release and help slow down the growth of the fibroids.
Q: Are there ways to reduce the symptoms of uterine fibroids?
A: Because one of the main symptoms is excessive bleeding, patients can become anemic, which will cause them to feel extremely tired or sluggish. One of the ways to address anemia is to prescribe iron supplements and monitor blood levels. As far as the pain and pressure, there are pain medications that can ease the symptoms. However, the most effective way to reduce the symptoms is to treat the fibroids themselves.
Q: What exactly is Uterine Fibroid Embolization?
A: Uterine Artery Embolization is a technique that’s been used for at least 20 years. It’s become increasingly popular because we’ve become highly skilled at it, and we have the tools to perform it effectively and safely.
Basically there are two arteries that supply blood flow to the uterus—one on the left and one on the right. As fibroids grow, they consume all the blood flow from these two arteries. By selecting the two arteries with our small catheters, we can inject small particles that block those arteries and cut off the blood flow. By cutting off the blood flow, you’re basically starving the fibroids of blood, which causes them to shrink, scar down, and die. When fibroids are present, the tissue in the uterus learns to acquire blood from other arteries in the area. With this procedure, you’re eliminating the fibroids without harming the uterine tissue.
Q: What’s the difference between Uterine Fibroid Embolization and a Hysterectomy?
A: Uterine Fibroid Embolization is a procedure where we make a small puncture in your blood vessel. We then thread a catheter into the arteries that supply blood flow to the uterus. We inject particles to cut off that blood flow. Uterine Fibroid Embolization is a same-day procedure.
In comparison, a hysterectomy is when a surgeon makes an incision and removes the uterus. In most cases, a hysterectomy requires a hospital stay and additional recovery time at home. In addition, there are increased risks with a hysterectomy because the uterus is in such close proximity to several other organs including your bladder, other muscles, and blood vessels in the area. We generally don’t encounter these complications when we perform Uterine Fibroid Embolization.
Q: What is the recovery time for Uterine Fibroid Embolization and for a Hysterectomy?
A: Uterine Fibroid Embolization is generally a same-day procedure. You’ll come in on the day of the procedure. The procedure itself takes about an hour, recovery is three to four hours, and then you can go home. There will be some discomfort because we’ve cut off the blood flow, so, the fibroids become dying tissue. These symptoms can be managed, but we usually tell our patients to take it easy and avoid physical activity for five days.
Hysterectomies, on the other hand, require a hospital stay. The stay could require one to two days depending on your case and if there were any complications. In addition, the incision requires seven to 10 days of recovery time at home.
Q: When should a woman seek treatment for uterine fibroids?
A: There are fibroids the size of a penny or a nickel that are asymptomatic. Women may not even know they have fibroids. Unfortunately, fibroids need to reach a certain size in order to cause symptoms and require treatment. For example, some women may have excessive bleeding that becomes life-limiting, meaning they can’t leave the house or go to work. They may also develop anemia. There are also some women who can’t manage the pain, the pressure, and the associated symptoms of the fibroids pushing on adjacent organs, such as the bladder. Fibroids can also cause difficulty with sexual activity, which is also life-limiting. Once fibroids limit your life to where you can’t function normally, we’ll want to determine if Uterine Fibroid Embolization can help.