Halting Hysterectomies: Unique uterine fibroid treatment

Nearly 80 percent of women in the U.S. will suffer with uterine fibroids at some point in their lives. One in four of those will need treatment.

The benign tumors can cause cramping, heavy periods, and frequent urination. Now new technology is helping treat fibroids without removing the uterus.

Tracy Patches had numerous tumors, called fibroids, causing bladder issues and bloating.

"I had one that was a cantaloupe size,” says Tracy Patches who suffered with uterine fibroids. “I had another that was an orange size."

Every year 300,000 American women have hysterectomies because of fibroids. Tracy considered it but was worried about the possible six week recovery time. So she opted for a minimally invasive treatment that Doctor Atul Gupta helped develop. The new procedure involves fusing a patient's existing MRI with 3D imagery to create a detailed map of the uterus and fibroids.

"And so the red is our human GPS and we're guiding our catheters and wires into these little tiny uterine arteries using the roadmap from the MRI," explains Dr. Atul Gupta the Director of Interventional Radiology at Paoli Hospita Main Line Health.

Tiny plastic microspheres are injected to cut off the fibroids' blood supply. They die and are absorbed by the body. The technique uses up to 70 percent less radiation and 50 percent less x-ray dye.

"There's no stitches, no scarring, no blood loss,” says Dr. Gupta. “And for many women what they appreciate about the procedure so much is we maintain their uterus. We do not remove their uterus."

Tracy was back to work in less than a week symptom free and feeling great.

"It was the best decision I ever made," explains Patches.

Paoli Hospital in Pennsylvania is the only facility in the world offering the new FDA approved treatment. The technique is successful in 90 percent of cases. Otherwise, a hysterectomy can still be performed.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC: Halting Hysterectomies: Unique uterine fibroid treatment
REPORT: MB # 3528

BACKGROUND: Uterine fibroids are non-cancerous growths of the uterus that often appear during your childbearing years. Also called fibromyomas, leiomyomas or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer. As many as 3 out of 4 women have uterine fibroids sometime during their lives, but most are unaware of them because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound. In general, uterine fibroids seldom require treatment. Medical therapy and surgical procedures can shrink or remove fibroids if you have discomfort or troublesome symptoms. Rarely, fibroids can require emergency treatment if they cause sudden, sharp pelvic pain or profuse menstrual bleeding. (Source: mayoclinic.com)

SIGNS AND TYPES: In women who have symptoms, the most common symptoms of uterine fibroids include: heavy menstrual bleeding, prolonged menstrual periods - seven days or more of menstrual bleeding, pelvic pressure or pain, frequent urination, difficulty emptying your bladder, constipation, backache or leg pains. Rarely, a fibroid can cause acute pain when it outgrows its blood supply. Deprived of nutrients, the fibroid begins to die. Byproducts from a degenerating fibroid can seep into surrounding tissue, causing pain and fever. A fibroid that hangs by a stalk inside or outside the uterus (pedunculated fibroid) can trigger pain by twisting on its stalk and cutting off its blood supply. Fibroid location influences your signs and symptoms: Submucosal fibroids: Fibroids that grow into the inner cavity of the uterus (submucosal fibroids) are thought to be primarily responsible for prolonged, heavy menstrual bleeding and are a problem for women attempting pregnancy. Subserosal fibroids: Fibroids that project to the outside of the uterus (subserosal fibroids) can sometimes press on your bladder, causing you to experience urinary symptoms. If fibroids bulge from the back of your uterus, they occasionally can press either on your rectum, causing constipation, or on your spinal nerves, causing backache. See your doctor if you have: pelvic pain that doesn't go away, overly heavy or painful periods, spotting or bleeding between periods, pain with intercourse, difficulty emptying your bladder, or difficulty moving your bowels. Seek prompt medical care if you have severe vaginal bleeding or sharp pelvic pain that comes on suddenly. (Source: mayoclinic.com)

HYSTERECTOMY AND FIBROIDS: Hysterectomy is the surgical removal of the uterus. The ovaries may also be removed, although this is not necessary for fibroid treatment. Hysterectomy is a permanent solution for fibroids, and is an option if other treatments have not worked or are not appropriate. Traditionally, the most common treatment for uterine fibroid tumors is to remove the entire uterus in a surgical procedure . Many physicians continue to recommend hysterectomy as the standard in uterine fibroid tumor treatment, sometimes because they are not familiar with newer, less invasive options. In fact, two-thirds of the 600,000 hysterectomies performed each year in the U.S. are for treatment of uterine fibroid tumors. (Source: Dr.Fibroid.com)
NEW TECHNOLOGY: A new procedure developed by Dr. Atul Gupta involves combining patient images from multiple modalities like MRI and CT scan to create a real-time 3-D map that displays the instrument position, orientation, and trajectory, as well as anatomical landmarks. This 'map' helps to guide physicians to areas of interest, even when they are small, hard to visualize, difficult to access, or close to sensitive organs, vessels, or tissue.

"The catheter that we guide through the body is 18/1000 of an inch in diameter. This is why the procedure is minimally invasive and requires no scars or incisions," Dr. Atul Gupta, M.D., Director of Interventional Radiology at Paoli Hospital, told Ivanhoe. "What we are doing is we are plugging up the arteries that supply the fibroids and basically we are choking off the blood supply." (Source: PR Newswire, Interview with Dr. Atul Gupta)

FOR MORE INFORMATION, PLEASE CONTACT:

Bridget Therriault
Manager of Communications
therriaultb@mlhs.org
1-866-CALL-MLH


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