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Fibroid

Interventional radiology offers a minimally invasive option for fibroid treatment, eliminating the need for surgical intervention. Fibroids are benign tumors in the uterus that can often lead to issues like bleeding, pain, and infertility. One of the most common interventional radiology treatments for fibroids is uterine artery embolization.

What is Myoma?

Fibroids are benign (non-cancerous) tumors that originate from the muscular tissue of the uterus. They are most commonly found in women of reproductive age and can grow in response to hormonal changes. Depending on their size, number, and location, fibroids can cause a variety of symptoms.

Types of Myomas

Fibroids are classified based on their location in the uterus:

  • Submucosal Fibroids: These grow under the inner lining of the uterus (endometrium) and can increase menstrual bleeding.

  • Intramural Fibroids: Located within the muscle wall of the uterus, these can enlarge the uterus as they grow.

  • Subserosal Fibroids: These develop on the outer surface of the uterus and may cause pain by pressing on surrounding organs.

  • Pedunculated Fibroids: Attached to the uterus by a thin stalk, these can move and may cause pain if they twist.

Myoma Symptoms

Fibroids can present a variety of symptoms depending on their size and location:

Menstrual Changes:

  • Heavy menstrual bleeding (menorrhagia)

  • Prolonged periods

  • Bleeding between periods (metrorrhagia)

Pain and Discomfort:

  • Pressure and a feeling of fullness in the pelvic area

  • Abdominal and lower back pain

  • Pain during intercourse (dyspareunia)

Digestive and Urinary Issues:

  • Frequent urination

  • Difficulty urinating

  • Constipation and bloating

Reproductive and Pregnancy Issues:

  • Infertility

  • Increased risk of miscarriage

  • Preterm labor or birth complications

Note: In some women, fibroids may cause no symptoms at all and are often discovered during routine gynecological exams.

Miyomların Tanısı

Fibroids are diagnosed using the following imaging methods:

  • Ultrasonography: Shows the location, size, and number of fibroids in the uterus.

  • Magnetic Resonance Imaging (MRI): Provides more detailed images, helping to determine the exact location and structure of the fibroids.

  • Hysteroscopy: Used to directly view the inside of the uterus and assess submucosal fibroids.

  • CT (Computed Tomography): Often preferred for large fibroids and to evaluate their relationship with surrounding organs.

Treatment of Fibroids

Fibroids do not always require treatment. Small fibroids that do not cause symptoms can be monitored with regular follow-up. However, treatment is necessary for fibroids that cause symptoms or grow rapidly. Interventional radiology offers minimally invasive methods that provide successful results in fibroid treatment.

​Myoma Treatment with Interventional Radiology: Uterine Arterial Embolization (RAE)

Uterine Artery Embolization is a treatment method that cuts off the blood supply to fibroids, causing them to shrink and reducing symptoms. This method does not require surgical intervention and is especially ideal for women who face surgical risks or wish to preserve their uterus.

How is Uterine Arterial Embolization Performed?

  • Preparation:

  • Detailed imaging (MRI or ultrasound) is performed before the procedure to locate the fibroids.

  • Local anesthesia is applied, ensuring the patient does not feel pain during the procedure.

  • Procedure Steps:

  • A small incision is made in the groin area, and a thin catheter is inserted into the femoral artery (thigh artery).

  • Under imaging guidance, the catheter is directed to the arteries that supply blood to the uterus.

  • Special embolization materials are injected into the blood vessels feeding the fibroids.

  • These materials block the blood flow to the fibroids, cutting off their nourishment and causing them to shrink over time.

  • After the Procedure:

  • The procedure usually lasts 1-2 hours, and the patient can be discharged on the same day.

  • Mild cramping may occur in the first few days, but the pain is typically controlled with painkillers. In some cases, hospitalization may be required due to pain.

  • The fibroids gradually shrink over the following weeks and months, and symptoms lessen.

Advantages of Uterine Arterial Embolization

  • Minimally Invasive: No surgical incision is made; only a small hole is created.

  • Quick Recovery: The patient can return to normal life in a short period of time.

  • Uterus Preservation: While fibroids shrink, the uterine tissue remains unharmed.

  • Simultaneous Treatment of Multiple Fibroids: All fibroids can be treated in the same procedure.

  • High Success Rate: In the majority of patients, symptoms disappear or significantly reduce.

Who is Suitable for Uterine Arterial Embolization?

  • Those experiencing severe menstrual bleeding, pelvic pain, or a feeling of pressure

  • Those who want to avoid surgical intervention

  • Those who do not wish to have a hysterectomy

  • Those seeking a shorter recovery time

  • Those with anesthesia risks or who are not suitable candidates for surgery

  • Note: If planning for pregnancy, it is important to have a detailed evaluation with your doctor before making a decision.

Side Effects and Risks

  • There may be pain and cramping for a few days after the procedure.

  • Mild fever and fatigue may occur.

  • Rarely, infection or allergic reactions may develop.

  • Menstrual irregularities may occur, but most women return to their normal menstrual cycle.

Life After Myoma Treatment

  • A short rest period is required after the procedure, but most patients return to normal activities within a few days.

  • Menstrual bleeding decreases, and pelvic pain and pressure sensation disappear.

  • As the fibroids shrink, the pressure on the urinary and digestive systems reduces.

  • Regular follow-up appointments are necessary to monitor the condition of the fibroids.

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