( continued from page 17 ) Bulk symptoms can take two to three weeks to subside as fibroid size shrinks by approximately half . Several studies have shown that at six months , 90 % of women who underwent UAE had significant or complete resolution of both bleeding and bulk-related symptoms . 7
One potential drawback worth considering is that fibroids can recur after UAE . However , only 20 % of women , especially younger patients , pursue reintervention within five years following the procedure . 7
UAE AND FERTILITY
Fertility following UAE is still not fully understood because of two confounding factors : advanced age and fibroids that already affect fertility . 8 Data supports that pregnancy is possible after UAE , however , if a woman anticipates a future pregnancy , a discussion regarding the two options should be had with patient . Research has shown that uterine damage is unlikely . 1
FUTURE DIRECTIONS
Fibroids are the leading indicator for hysterectomies in the U . S . A 2017 poll of women diagnosed with fibroids conducted by the Society of Interventional Radiology reported that one in five women believe a hysterectomy is the only treatment option . Nearly half of respondents were unaware of UAE . Interestingly , the survey also revealed that more than half of respondents believe that discussing all options is the most important factor for selecting a treatment . 9
To develop awareness about the myriad fibroid treatments , primary care physicians , OB-GYNs and interventional radiologists must increase collaboration to educate patients about all options and design individualized care . This includes discussing with patients the many benefits and low-risk profile of uterine artery embolization .
MAIN POINTS
1 . Symptomatic fibroids cause heavy bleeding , pelvic pain and bulk symptoms that can significantly harm quality of life .
2 . Uterine artery embolization , first performed over 20 years ago , is a minimally invasive and uterus-sparing treatment performed by interventional radiologists and recognized by ACOG for symptomatic fibroids .
3 . Many women are unaware of UAE . Therefore , more patient education and collaboration among physicians regarding all fibroid treatment options is needed .
References :
TWO PATIENTS IN ONE
1
Spies JB . Current evidence on uterine embolization for fibroids . Semin Intervent Radiol . 2013 Dec ; 30 ( 4 ): 340-6 . doi : 10.1055 / s-0033-1359727 . PMID : 24436560 ; PMCID : PMC3835459 .
2
Society of Interventional Radiology - uterine fibroids . [ cited 2022Jan30 ]. Available from : https :// www . sirweb . org / patient-center / conditions-and-treatments / uterine-fibroids /
3
Sohn GS , Cho S , Kim YM , Cho CH , Kim MR , Lee SR ; Working Group of Society of Uterine Leiomyoma . Current medical treatment of uterine fibroids . Obstet Gynecol Sci . 2018 Mar ; 61 ( 2 ): 192-201 . doi : 10.5468 / ogs . 2018.61.2.192 . Epub 2018 Feb 13 . PMID : 29564309 ; PMCID : PMC5854898 .
4
Donnez J , Dolmans MM . Uterine fibroid management : from the present to the future . Hum Reprod Update . 2016 Nov ; 22 ( 6 ): 665-686 . doi : 10.1093 / humupd / dmw023 . Epub 2016 Jul 27 . PMID : 27466209 ; PMCID : PMC5853598 .
5
American College of Obstetricians and Gynecologists ’ Committee on Practice Bulletins – Gynecology . Management of Symptomatic Uterine Leiomyomas : ACOG Practice Bulletin , Number 228 . Obstet Gynecol . 2021 Jun 1 ; 137 ( 6 ): e100-e115 . doi : 10.1097 / AOG . 0000000000004401 . PMID : 34011888 .
6
Dariushnia SR , Nikolic B , Stokes LS , Spies JB ; Society of Interventional Radiology Standards of Practice Committee . Quality improvement guidelines for uterine artery embolization for symptomatic leiomyomata . J Vasc Interv Radiol . 2014 Nov ; 25 ( 11 ): 1737- 47 . doi : 10.1016 / j . jvir . 2014.08.029 . Epub 2014 Oct 23 . PMID : 25442136 .
7
Uterine fibroid embolization ( UFE ) [ Internet ]. Radiologyinfo . org . 2020 [ cited 2022Jan30 ]. Available from : https :// www . radiologyinfo . org / en / info / ufe
8
Mohan PP , Hamblin MH , Vogelzang RL . Uterine artery embolization and its effect on fertility . J Vasc Interv Radiol . 2013 Jul ; 24 ( 7 ): 925-30 . doi : 10.1016 / j . jvir . 2013.03.014 . Epub 2013 May 20 . PMID : 23701904 .
9
The fibroid fix - what women need to know [ Internet ]. SIR Report . Society of Interventional Radiology ; 2017 [ cited 2022Jan30 ]. Available from : http :// test . sirweb . org / globalassets / aasociety-of-interventional-radiology-home- page / patient-center / fibroid / sir _ report _ final . pdf
Akhila Ankem is a fourth-year medical student at the University of Louisville School of Medicine .
Dr . Contractor is Professor and Chair , Radiology / Interventional Radiology , with the UofL School of Medicine / UofL Health .
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