Uterine Fibroids
Uterine Artery Embolisation (UAE)
Uterine artery embolisation is now a well established minimally invasive treatment option for women with uterine fibroids, one of the commonest gynaecological problems that can lead to symptoms such as heavy periods, period pain and pressure symptoms, all of which interfere with daily activities.
The following sections explain what fibroids are, what treatments are available and how embolisation compares with the other treatment options. Since each patient is unique, you should consider any information on this site in conjunction with your Gynaecologist’s advice. You can download a patient information booklet and contact us to make an appointment to discuss your individual situation in more detail.
We have over 10 years experience doing UAE for both NHS and private patients.
What are fibroids?
Fibroids are abnormal growths of the muscle wall of the womb (uterus). Uterine fibroids are the most common benign disease of the female genital tract. The medical names for fibroids include leiomyoma, leiomyomata, myoma and fibromyoma. Fibroids are non-cancerous (benign) growths. Most often, fibroids do not cause symptoms; however, their size and location can lead to problems for some women including painful or heavy periods and pressure symptoms, most commonly pressure on the urinary bladder. Fibroids may occur in a number of locations. They most commonly lie in the wall of the uterus (intramural fibroids) but may protrude either outside the uterus or into the cavity of the uterus.
How common are fibroids?
Uterine fibroids are very common. The number of women who have fibroids increases with age until menopause: about 20% of women in their 20s have fibroids, 30% in their 30s and 40% in their 40s. From 20-40% of women aged 35 and older have uterine fibroids of a significant size. Fibroids are more common in certain ethnic groups.
What treatments are available?
1. Do Nothing – Fibroids are very common and only need treatment if causing problems such as pain, heavy menstrual bleeding or pressure on adjacent organs such as the bladder.
2. Medical treatment with tablets or injections to manipulate hormones that affect fibroid growth. Fibroids tend to re-grow when such hormonal treatment is stopped though they can shrink again with menopause.
3. Myomectomy is a surgical procedure carried out by a Gynaecologist that removes just the fibroids, not the entire uterus. Not all fibroids are suitable and the surgery may carry a risk of conversion to hysterectomy due to blood loss. Your Gynaecologist can discuss the advantages and disadvantages in your particular case.
4. Hysterectomy (surgical removal of the womb by a Gynaecologist) has been the most common therapy in the past for women who have fibroids and is effective when menstrual bleeding is a problem because clearly, women can no longer menstruate. Although a more major undertaking than some of the other options and with a longer recovery period, hysterectomy is the best choice for many women and should not be excluded without full understanding and discussion.
5. Endometrial Ablation is a treatment particularly suited to sub-endometrial fibroids lying under the lining of the cavity of the uterus. There are various types of endometrial ablation which are performed by Gynaecologists via a probe inserted through the cervix.
6. Uterine artery embolisation (UAE), also known as Uterine fibroid embolisation (UFE) is a more recent treatment first developed in France in the early 1990s although used for other indications before then. Well over 500,000 fibroid embolisations have been performed worldwide and the procedure is now a mainstream option.
7. MRI Guided Focused Ultrasound Ablation (MRgFUS) which focuses ultrasound waves on the fibroids and destroys them. Availability is limited at present and it is only suitable for certain types of fibroids
