Uterine Fibroids: Options Beyond Hysterectomy

Uterine fibroids

My sister is currently 37 years old.
Over four years ago, she underwent a fibroid removal surgery.
Last year, the fibroids recurred, and at that time, the largest one was about 6 centimeters.
However, during a follow-up two weeks ago, it was found that the largest fibroid has increased to 10 centimeters.
She also experienced lower back pain the day before yesterday, so she is considering the doctor's recommendation to undergo a total hysterectomy.
However, I came across a new procedure called embolization, which may avoid the need for a complete hysterectomy.
Is this true? I wonder if my sister is a candidate for this method at this stage.
Additionally, are there any other potential side effects associated with this procedure?

Joyce Chiu, 30~39 year old female. Ask Date: 2002/05/03

Dr. Lin Manying reply Obstetrics and Gynecology

1.
The so-called uterine blood flow occlusion method has not passed human trials and its efficacy is uncertain; therefore, the Department of Health has explicitly prohibited physicians from performing it privately.
2.
If the patient (1) no longer requires fertility (2) has a uterine size exceeding 12 cm (3) has rapidly growing fibroids (4) experiences symptoms such as abdominal pain, lower back pain, pressure, heavy menstrual bleeding, and irregular menstrual cycles (5) has previously undergone myomectomy with recurrence, a total hysterectomy is recommended.

Reply Date: 2002/05/03

More Info

Uterine fibroids, also known as leiomyomas, are non-cancerous growths that develop in the uterus. They are quite common, especially in women of reproductive age, and can cause a variety of symptoms, including heavy menstrual bleeding, pelvic pain, and pressure symptoms. In your sister's case, it appears that she has experienced recurrent fibroids, leading to significant growth and associated symptoms, prompting the consideration of a hysterectomy.

Hysterectomy, the surgical removal of the uterus, is a definitive treatment for uterine fibroids, especially when they cause severe symptoms or complications. However, it is important to explore all available options before making such a significant decision, particularly for a woman who may wish to preserve her fertility.

One alternative to hysterectomy is uterine artery embolization (UAE). This minimally invasive procedure involves blocking the blood vessels that supply the fibroids, leading to their shrinkage and alleviation of symptoms. UAE can be an effective option for women who wish to avoid major surgery and preserve their uterus. Studies have shown that UAE can significantly reduce fibroid-related symptoms and improve quality of life for many women.

Regarding your sister's eligibility for UAE, several factors must be considered:
1. Size and Location of Fibroids: UAE is typically effective for fibroids that are larger than 3 cm and located within the uterine wall. However, very large fibroids, such as the 10 cm fibroid your sister has, may pose challenges. The success of UAE can vary based on the size and number of fibroids.

2. Symptoms: If your sister is experiencing significant symptoms, such as severe pain or heavy bleeding, UAE may be a suitable option. It is essential to discuss her symptoms and their impact on her daily life with her healthcare provider.

3. Overall Health: Your sister's overall health and any underlying medical conditions will also play a role in determining her suitability for UAE.
4. Desire for Future Fertility: If your sister wishes to retain her fertility, UAE may be a preferable option compared to hysterectomy.

As for potential side effects or complications of UAE, they can include:
- Post-Embolization Syndrome: This can involve pain, fever, and nausea following the procedure, typically resolving within a few days.

- Infection: As with any procedure, there is a risk of infection.

- Fibroid Regrowth: While UAE can shrink fibroids, there is a possibility that they may regrow over time.

- Menstrual Changes: Some women may experience changes in their menstrual cycle after UAE, including irregular bleeding or changes in flow.

It is crucial for your sister to have a thorough discussion with her healthcare provider about the risks and benefits of UAE compared to hysterectomy. A gynecologist specializing in fibroid treatment can provide personalized recommendations based on her specific situation.

In conclusion, while hysterectomy is a definitive solution for uterine fibroids, UAE offers a less invasive alternative that may be suitable for your sister, especially if she wishes to preserve her uterus and potentially her fertility. A detailed evaluation by a healthcare professional will help determine the best course of action tailored to her needs and circumstances.

Similar Q&A

Uterine Fibroids: Surgical Options and Risks for Women Over 40

Hello, doctor. My younger sister is 41 years old, unmarried, and has never had children. Recently, she was diagnosed with a uterine fibroid measuring approximately 8 cm, accompanied by periodic pain. The doctor has recommended surgery. Should she opt for tumor removal or a hyster...

Dr. Lin Wenbin reply Obstetrics and Gynecology
Please go to the hospital for an examination. In addition to surgery, there are now medications available to treat uterine fibroids. Treatment options should be discussed based on individual circumstances.

Managing Uterine Fibroids: Non-Surgical Options and Treatment Insights

Dear Dr. Lin, I have three fibroids in my uterus, each approximately 2 to 3 centimeters in size. I am currently managing them with medication (progesterone, taken for two months), but over the past month, I have experienced a significant increase in menstrual blood flow accompan...

Dr. Lin Manying reply Obstetrics and Gynecology
Hello: Fibroids are common benign tumors of the uterus. Although 40% are asymptomatic, those who do experience symptoms often report heavy menstrual bleeding with clots, abdominal pain, a feeling of heaviness, and pressure. However, before confirming surgery or treatment, it is e...

Managing Uterine Fibroids: Alternatives to Hysterectomy for Heavy Bleeding

I would like to ask about my mother, who is currently 48 years old. In recent months, she has been experiencing heavy menstrual bleeding that is difficult to control, which makes her feel weak and fatigued. She has undergone an ultrasound at the hospital, and the doctor mentioned...

Dr. Dong Yuhong reply Obstetrics and Gynecology
Hello: Based on your description, your mother is 48 years old and has been experiencing heavy menstrual bleeding that is difficult to control over the past few months. She feels physically weak and has a sensation of her legs giving way. An ultrasound at the hospital revealed a 3...

Understanding Uterine Fibroids: Treatment Options and Surgical Considerations

Hello, doctor. I would like to inquire about my situation. I have been diagnosed with uterine fibroids after undergoing tests at the hospital. I was initially scheduled for surgery, but the doctor later discovered that the tumor is too large, approximately 12 centimeters. To prot...

Dr. Huang Jianxun reply Obstetrics and Gynecology
Dear Fang, As per your description, your physician has informed you of the treatment options available. If you are unsure about how to decide, please discuss it further with your physician. Wishing you peace and good health. Sincerely, Dr. Huang Chien-Hsun Director, Dep...