By the age of 50, up to 70% of women in Australia could be affected by uterine fibroids, however, it’s likely that many are unaware of the minimally invasive uterine fibroid embolisation treatment (UFE) available, and instead undergo invasive and potentially unnecessary surgery.

A recent US poll released in August 2017 by the Society of Interventional Radiology found that only 44% of US women diagnosed with uterine fibroids have ever heard of UFE. The poll also indicated wide misconceptions about uterine fibroids including development risks and treatment options.

What Are Uterine Fibroids

Uterine fibroids (also known as leiomyoma) are very common, benign (non-cancerous) growths that develop in the muscle wall of a woman’s uterus. These fibroids are common in fertile women, and usually shrink after menopause.

Fibroids often produce no obvious symptoms (asymptomatic), with patients unaware of their presence until found incidentally on examination or via medical imaging. However, fibroids can cause symptoms depending on their size and location. Symptoms may include pelvic pain, heavy bleeding, increased period pain, and increased frequency of urination. Fibroids can also be associated with infertility.

Whilst invasive surgeries and procedures like hysterectomies and ablations are necessary for many conditions, they may not be needed to treat uterine fibroids. Sometimes, however, they are presented as the one or best option to treat these non-cancerous growths.

A minimally invasive alternative is Uterine Fibroid Embolisation (UFE).

What is Uterine Fibroid Embolisation?

Uterine Fibroid Embolisation (UFE) has been used to treat uterine fibroids for over 20 years and has an established role in the management of symptomatic fibroids. This procedure is conducted under sedation and a local anaesthetic and can only be performed by a specialist interventional radiologist with expertise in the area.

UFE involves a tiny catheter being inserted through the wrist or groin and manoeuvred into the uterine artery under X-ray guidance. Tiny particles are then inserted into the arteries supplying the fibroids, reducing their blood flow and causing them to shrink and die over time. The whole procedure takes about 90 minutes and no abdominal incisions or stiches are required.

Benefits of UFE

• • UFE is a very effective procedure with a success rate of approximately 85% and is approved by Medicare.

• • The procedure offers a fast recovery and is very well tolerated; most patients can go home the next day.

• • It’s minimally invasive and safer than other alternatives; the risk of major complications is much lower for UFE than other surgical treatment options.

• • Most patients see a dramatic improvement in their symptoms and a decrease in the size of their uterine fibroids.

UFE is endorsed by the Australian RANZCOG who state that the UFE is an effective, less invasive alternative to traditional methods, with fewer complications and a quicker recovery.

Risks of UFE

UFE is generally considered to be a very safe procedure, however, like all medical procedures it carriers a small risk of complications, including:  

• • Fibroid detachment – up to 3% of women will pass small pieces of fibroid some months after the procedure, because of the fibroid dying and detaching from the uterine wall. It is not usually dangerous.

• • Haematoma – a small bruise may form at the needle’s insertion site, but this is quite normal and usually requires no intervention.

• • Pelvic Pain – patients may experience some mild pelvic pain in the days following the procedure. This pay may feel like period pain and usually be managed with over-the-counter painkillers.

• • Infection – the uterus and needles insertion site may become infected if not adequately cared for following the procedure.

• • Hysterectomy – in very rare cases, UFE can lead to severe infections and complications which result in the uterus needing removal.

VIRQ work collaboratively with GPs and Gynaecologists to offer you the right treatment for your fibroids. If you suffer from uterine fibroids, your GP or gynaecologist can organise a referral to VIRQ for a discussion about how UFE may benefit you.

Minimally invasive treatment for painful varicose veins

Vascular & Interventional Radiology Queensland (VIRQ) offers varicose veins treatments incorporating the latest endovascular techniques. Highly skilled interventional radiologists at our Queensland clinics use a minimally invasive approach to treat symptomatic veins with either thermal ablation or non-thermal adhesives.

VIRQ Vascular and Interventional Radiologist, Dr Nicholas Brown, who has specialist training in this area, said the endovascular approach was highly beneficial to patients.

“The ultrasound guided treatment is minimally invasive and patients won’t require general anaesthetic. Performed as a day case, the treatment is quick and requires very little downtime, ensuring that patients can get back to normal activities as soon as possible. The treatments we use all show excellent long-term effectiveness for symptomatic varicose veins.”

What are Varicose Veins?

Veins carry blood back to the heart. Blood is pushed along by movement of the body/muscle activity and prevented from sliding back by valves. If these valves fail to function properly, which can be caused by a range of factors, blood pools in the veins that become lumpy knots. When these veins become swollen and congested, they are called varicose veins.

Why treat Varicose Veins?

Varicose veins are often painful and can be unsightly but are usually not life-threatening. While some people do not have any symptoms, it is common to experience pain, a sense of heaviness, itchiness or swelling. If left untreated, they may get worse over time and can lead to more serious conditions, including inflammation and leg ulcers.

How does treatment work?

Options for treatment include compression garments, surgical removal, and sclerosing/ablative techniques such as radiofrequency ablation, laser ablation or endovenous glue. The endovascular treatment options offered by VIRQ are minimally invasive, highly effective and typically last for a long time.

Booking a consultation with a specialist VIRQ Interventional Radiologist requires a referral from a GP or specialist. Contact VIRQ for further information about this procedure. 

Benign enlargement of the prostate is not uncommon or unexpected in men of a certain age. It causes urinary problems with symptoms such as a weak stream, never properly emptying the bladder, always wanting to urinate and getting up a lot during the night.

Treatments include medications that can have side-effects and aren’t always effective, and surgery to reduce the size of the prostate by coring it out, either with a knife or a laser.

An alternative technique that has become more common in recent years is prostate artery embolisation, performed by an interventional radiologist.

What Is Prostate Artery Embolisation

Prostate artery embolisation is a procedure that is performed by an interventional radiologist. It involves directing very small catheters and wires through through an artery in the groin or wrist into the arteries that supply blood to the prostate.

The prostate artery blood supply is then blocked by using very small microscopic beads. Without a blood supply, the prostate shrinks down and softens up, relieving enlarged prostate symptoms.

Effectiveness of the procedure

Studies conducted by a Brisbane interventional radiology team (https://virq.com.au/research/) found that prostate artery embolisation is a very effective way of shrinking down the prostate. It showed a reduction in prostate volume of approximately 30%. These studies are mirrored by numerous overseas studies.

The procedure targets the central part of the prostate. The aim is to reduce the amount of tissue, the crowding, the obstruction around the urethra and the pressure on the bladder, taking away the blood supply and shrinking the prostate.

Most men can expect somewhere in the vicinity of 3 to 5 years’ worth of relief, and it’s a minimally invasive and low risk procedure, which can be repeated if necessary.

Although this results in a decrease in symptoms and improved quality of life, a limitation is that new blood vessels grow back, and the prostate will continue to grow.

Risks

Many patients ask if there is a risk of using an incorrect blood vessel, however, the technology used, combined with the expertise of the interventional radiologist, makes this a very safe procedure. It’s also minimally invasive and doesn’t have the side effects of surgical treatments.

One of the great advantages is it’s a minimally invasive day surgery, and it doesn’t have side-effects that are associated with the surgical treatment, which means no retrograde ejaculation, no impotence, no incontinence. The beads end up in the prostate and nowhere else and they do what they are designed to do.

Side Effects

After the procedure, patients can expect a period of symptoms, usually lasting for 5 to 7 days, some burning when they go to the toilet, some increased frequency, a temporary increase in the frequency before everything settles down and inflammation resolves itself.

About A/ProfNick Brown

A/Prof Nick Brown, specialises in Interventional Radiology, with particular interests in interventional oncology, thoracic interventions, sports medicine, uroradiology and health economics. A/Prof Nick Brown was interviewed by Dr Norman Swan on Radio National’s The Health Report about prostate artery embolisation.

Listen to A/Prof Brown’s interview with Dr Norman Swan.

Learn more about the Prostate Artery Embolisation procedure performed by the VIRQ team.