Who is the ideal candidate for uterine fibroid embolization
The ideal candidate for uterine fibroid embolization (UFE) is generally any women diagnosed with fibroids that we can be reasonably sure are causing the symptoms. Deciding if a patient is an ideal candidate compared to other treatment options depends on a several factors, including the size and number of the fibroids, the location of the fibroids, the symptoms the fibroids cause and the patient’s plans for having children in the future. Below, we will discuss the logic behind each of the factors affecting a woman’s candidacy for uterine fibroid embolization.
We consider the size and number of fibroids a woman has
The size of the fibroid is a practical consideration when deciding if it is causing symptoms. Fibroids can range in size from less than a centimeter in size to greater than 20 cm in size, occupying most of the abdominal space. Common sense can guide us as to what symptoms fibroids can reasonably cause. For example, a one centimeter intramural fibroid likely isn’t causing a patient’s back pain or bloating, but a 12 cm fibroid certainly may be. In this instance, woman with a 12-centimeter fibroid would be an ideal candidate for uterine fibroid embolization.
Women with a single fibroid likely causing symptoms and women with many culprit fibroids generally have different available options. In the instance of a single fibroid, UFE is an option, but additional focal surgical therapies such as ablation or surgical excision, also known as a myomectomy, may also be an option. In the case of numerous culprit fibroids, say four or more, treatment of a single fibroid has a higher likelihood of failure to resolve symptoms. In this case, a procedure like UFE that treats all fibroids within the uterus is likely preferable.
The location of fibroids can help determine which procedure is ideal for a patient
Fibroids can be located from the inside to the outside of the uterus, from the cervix to the fundus and from the front to the back of the uterus. A fibroids location within the uterus will determine what treatment options are available. For example, a surgeon could easily access a fibroid growing from the lining of the uterus with a minimally invasive hysteroscopy that requires no abdominal incisions, but a fibroid growing from the outside of the uterus could not be.
Symptoms and the desire for future pregnancies influence a patient’s choices
Problems from fibroids are variable, but most often include bleeding, pelvic pain, bulk symptoms and other abdominal complaints. Again, common sense is a great guide, and the size and location of the fibroid should match up with the symptoms patients are experiencing. For example, a woman with 12 fibroids throughout an enlarged uterus can reasonably expect to have good relief of heavy menstrual bleeding and pelvic pain. Go to our page about symptoms of uterine fibroids for a more extensive list.
Women who are considering getting pregnant in the future need to consider their ability to conceive after UFE. While women can get pregnant after UFE, there may be other treatment options that will allow the uterus to retain more of the endometrium following treatment.
Our Austin interventional radiologist can determine the ideal candidate for uterine fibroid embolization
Women who have fibroids have many factors, including recovery from UFE vs. surgery, to consider when deciding on their best treatment. Patients should talk to our Austin interventional radiologist about whether or not they are the ideal candidate for uterine fibroid embolization. Contact us for an appointment.
