The Herald, Sharon, PA Published Sunday, June 17, 2001

SHARON

Uterine fibroids can be reduced without need for surgery

By Erin Remai
Herald Staff Writer

Women no longer have to live with painful uterine fibroid tumors, or resort to surgery to get rid of them.

A procedure called uterine fibroid embolization, which is available locally, is a nonsurgical treatment that reduces uterine fibroid growths.

Fibroids are noncancerous growths in the muscular wall of the uterus. They range in size from a quarter of an inch to 10 inches or more and can cause heavy menstrual bleeding, an increase in menstrual cramps, unusual monthly bleeding, pelvic pain, pain in the back or legs, pressure on the urinary system, pressure on the bowel and an abnormally enlarged abdomen, according to the Society of Cardiovascular and Interventional Radiology.

Dr. Vinay Madan, interventional radiologist with Sharon Regional Health System, said fibroids are very common and a woman's likelihood of developing them increases with age.

He said 30 percent of women age 40 and older have fibroids, and their chances increase every decade by 10 percent.

Madan said a patient with fibroids usually complains of bleeding, pelvic pain, obstruction of the kidneys or pain in the legs.

Fibroids usually shrink, calcify and turn into tiny balls once a woman hits menopause, when production of the hormones that cause fibroid growth lessens, Madan said.

The test for fibroids begins with an ultrasound, which will most likely reveal multiple masses in the uterus.

"Usually women will have more than one (fibroid)," Madan said.

In the past, a woman's only option was surgery, either to remove the fibroids or the uterus, Madan said.

In the new procedure, the radiologist injects small particles into uterine blood vessels to cut off the fibroids' blood supply.

The doctor inserts a catheter into a blood vessel in the woman's leg through a small nick in the skin. The doctor then moves the catheter to the uterine arteries using X-ray imaging and then injects polyvinyl alcohol particles into the tiny fibroid blood vessels.

"The whole goal is to get the particles into the small vessels that supply the fibroids," Madan said. "If you cut off the blood supply, they start to shrink."

Madan said the procedure is similar to a heart catheterization, except the catheter goes to the uterus instead of the heart.

The particles stay in the vessels forever, making the procedure permanent, Madan said.

A similar procedure can also be used to block the blood flow to tumors in cancer patients, Madan said.

Women who undergo the procedure spend one night in the hospital and are usually able to return to work in a week.

A woman who has had the procedure can still get pregnant, Madan said.



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