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wHAT aRE uTERINE fIBROIDS
Uterine fibroids are the most common pelvic tumor in women. Also known as leiomyomas, leiomyomatas or myomas, fibroids are benign (noncancerous) growths in the uterus that many women experience during childbearing years. Often, fibroids shrink in menopause. These tumors rarely develop into cancer. Women with fibroids often do not have symptoms, so they might be unaware that they have them. Fibroids are often found on routine gynecologic exams when the uterus feels enlarged.
If you are diagnosed with uterine fibroids and have no symptoms, there might be no need for treatment. Your physician will simply monitor their growth at your annual exams or more frequently if needed.
When the symptoms of uterine fibroids do interfere with daily life, Northwestern Medicine offers a range of treatment options, from medication to minimally invasive treatments and surgery. Our skilled and caring women’s health specialists can help you understand your options and recommend the best course of treatment for you.
Types of Fibroids
Fibroids vary in size from tiny masses that are not easily detectable to large growths that can enlarge the uterus. Symptoms of fibroids depend on their location within the uterus, and there are four common locations:
Symptoms of Uterine Fibroids
Many women with uterine fibroids have no symptoms or have only mild symptoms and never require treatment. However, depending on the size, location and number of fibroids, symptoms may include:
If you are concerned about any of these symptoms, talk to your physician. Northwestern Medicine is home to caring women's health specialists who can offer a range of treatment options to relieve your discomfort and prevent uterine fibroids from interfering with your daily life.
Treatments for Uterine Fibroids
Surgical Fibroid Therapies
Your doctor might recommend a surgical treatment for fibroids if:
Myomectomy — Myomectomy is a surgery done to remove fibroids which can reduce both bleeding and size-related symptoms. Most women who have myomectomy are able to have children afterwards. However, there is a risk that fibroids will come back after myomectomy; between 10 and 25 percent of women who have myomectomy will need a second fibroid surgery. For this reason, myomectomy is not the best choice for women who do not want future pregnancies.
There are several ways to perform myomectomy; the "best" way depends on where your fibroids are located and the size and number of fibroids.
Multimodal therapy — Northwestern Medicine has been at the forefront of using more than one therapy in patients with complex fibroids. This may include uterine fibroid embolization with hysteroscopic or laparoscopic myomectomy depending on your symptoms and the location of the fibroids.
Hysterectomy — Hysterectomy is a surgery that removes the uterus and cervix. The ovaries and tubes are often left in place when the hysterectomy is for uterine fibroids. Hysterectomy is a permanent treatment that cures heavy menstrual bleeding and the bulk related symptoms of fibroids. However, it is major surgery, and you will need up to six weeks to fully recover. Generally, we also recommend removing the fallopian tube at the same time to potentially lower the risk of ovarian cancer in the future without impacting your hormones. We also routinely recommend leaving the ovaries so that you do not experience menopause prematurely.
Uterine fibroid embolization (UFE)
UFE is a nonsurgical procedure that is used to shrink fibroids by halting the blood supply to the fibroid. The fibroids remain present but are smaller in size. This procedure allows your uterus to remain intact. At Northwestern Medicine, skilled interventional radiologists use imaging technology and a thin catheter to inject small particles into the arteries that supply blood in your uterus. These particles, most commonly made from polyvinyl alcohol, adhere to the blood vessel wall, causing a clot to develop that blocks the blood supply. Once the blood supply is gone, the fibroids shrink or die and your symptoms typically improve or stop completely.
A UFE procedure usually lasts less than one hour and calls for one small incision in your femoral artery. It may be performed on an outpatient basis or require a one-night stay in the hospital.
Benefits of UFE
If you are suffering from severe symptoms of uterine fibroids, UFE offers many possible benefits, including:
Risks of UFE
While infrequent, the most common complications associated with UFE are:
Some women go through menopause after having a UFE procedure. This is particularly true for women older than 45. Your uterus is not removed during UFE, so you could still become pregnant. However, more research is needed to determine exactly how this procedure affects fertility and pregnancy. Additional complications are possible with any procedure.
Some women experience post-embolization syndrome, which is described as having flu-like symptoms. It can occur within a few hours or a few days of your UFE procedure. Typically, symptoms last anywhere from two to seven days and include:
Which treatment is right for me?
There are many treatments for fibroids, and it can be hard to decide which one is right. You should choose a treatment based upon your fibroid-related symptoms and after discussing with your physician.
Why Choose Us
If you have uterine fibroids that are causing pain, heavy periods or other concerning symptoms, uterine fibroid embolization (UFE) may be the best treatment for you. Through Interventional Radiology fellowships, we have trained many physicians in this innovative, nonsurgical alternative to hysterectomy. Our interventional radiologists are national leaders in the field of UFE and faculty members at Northwestern University’s Feinberg School of Medicine.
At Northwestern Medicine, your care team includes specialized physicians, advanced practice nurses and a comprehensive support team devoted to treating women’s health conditions in a welcoming and compassionate environment
ENDOMETRIOSIS AND FIBROIDS: EXPERT PANEL Q&A
Northwestern Medicine’s Dr. Lauren Streicher speaks with three nationally renowned experts about the most commonly asked questions on endometriosis and fibroids, including leading edge alternatives to hysterectomies.
ABOUT MINIMALLY INVASIVE GYNECOLOGIC SURGERY
Our team offers less invasive alternatives to traditional gynecologic procedures in both the operating room and office settings.
Request an Appointment
To learn more about treatment options and how we can help, call 312.694.6447 to schedule an appointment.