Non surgical Fibroids Treatment

Freedom from Fibroids without Surgery! Uterine 10 Great Advantages of Uterine Artery Embolization for Fibroids Artery Embolization It is performed under Local anaesthesia. Not The Most advanced Non‐Surgical General anaesthesia. Treatment for Fibroids Requires only a tiny nick in the skin (No A NonSurgical surgical incision of abdomen). Treatment for, 1) Fibroids Recovery is shorter than from hysterectomy or open Myomectomy. 2) Adenomyosis 3)Endometriosis Within 3 days patient can attend the job. Without the surgical No Surgery Virtually no adhesion formation has been treatments like found. But in surgery adhesions are common. Quick Recovery Hysterectomy and Low Cost ( Details on Mymectomy. All fibroids are treated at once, which is not Page 8) the case with Myomectomy. There has been no observed recurrent growth of treated fibroids in the past 9 years. Get in touch with our Uterine Fibroid Embolization involves Medical Experts virtually no blood loss or risk of blood transfusion. International Patient Helpline Numbers Many women resume light activities in a few US/Canada Toll Free Number days and the majority of women are able to return to normal activities (including 1‐888‐771‐6965 exercise) within a week. If the presenting complaint was excess vaginal bleeding, 87 International Helpline Number 90% of cases experience resolution within 24hours. 0091‐9899993637 Emotionally, financially and physically benign procedure –Embolization can have an overall hospitalindia@gmail.com advantage over other procedures as the uterus is not removed. hospitalindia@yahoo.com

Success Story So far the world experience of Uterine Artery Embolization (UAE) for fibroids would indicate a success rate of over 85‐99%. Till recently we only had short and medium term follow up but now long term follow up data is available. Uterine artery embolization is now widely established particularly in the US and recently Condoleezza Rice's UAE was widely reported in the US press. National security adviser Condoleezza Rice Rice 'resting comfortably' after Non‐surgical treatment for fibroids Expected to return to work on Monday Friday, November 19, 2004 Posted: 4:07 PM EST (2107 GMT) WASHINGTON (CNN) ‐‐ National security adviser Condoleezza Rice, President Bush's nominee to be the next secretary of state, is doing well after successful Non‐surgical treatment for fibroids, Jim Wilkinson, deputy national security advisor, told CNN Friday. Rice is "out of surgery and resting comfortably after undergoing a successful uterine fibroid embolization at Georgetown University Hospital this morning," he said. "The minimally invasive procedure took an hour and a half and was performed by interventional radiologist James Spies." Rice will remain overnight in the hospital, returning home on Saturday. She is expected to return to work on Monday. Fibroid embolization is a minimally invasive alternative to hysterectomy, which allows for a rapid recovery and control of symptoms." ‐‐‐‐‐‐‐‐‐ CNN White House Correspondent Suzanne Malveaux contributed to this report. To know more such success stories please get in touch with us. hospitalindia@gmail.com US/Canada Toll Free Number: 1‐888‐771‐6965 hospitalindia@yahoo.com International Helpline Number: 0091‐9899993637

What do patients say? "Before embolization, my symptoms were excessive, heavy “I feel great!!! My doctor, Dr Pradeep Muley, bleeding, blood clots, painful cramps, lower back aches. I Interventional Radiologist, had three non‐ surgical procedures scheduled on that day and I was the was really fatigued and stressed and I felt real bloated and just miserable, basically. My doctor said that I had to have a last...scheduled at 1pm. I couldn't believe it was over so myomectomy. quickly...when I asked if he was done with one side, the nurses said that he was almost done with everything. I I did not want to have the myomectomy because I had a haven't had any pain and am still wondering when it myomectomy 05 years prior to that and I already had a was all done. Everything went fine and I was in my knowledge what the pain would be like. I found out about room by 3pm.On my way home from the hospital I embolization from a friend of mine who had sent me an stopped in with my Mother because I knew she would article from Times of India, English daily news paper, written be worried about me. She could not believe how good I by Dr.Pradeep Muley, an Interventional Radiologist.I found looked and how easily I was getting around without out that it wasn't going to be as invasive as a myomectomy. assistance. Within 40 hours of my procedure I was Embolization has changed my life because I no longer have outside working in my garden!! Pretty amazing!!!I feel to worry about the excessive bleeding, or will I have stains so good that I have to keep reminding myself that I don't have to go to work tomorrow. I can't imagine on my clothes, I can walk around, and I no longer have this aching in my lower back. I just feel so free."‐Ms.Jemila how I would be feeling right now if I had a hysterectomy.”‐Ms.MaryJo "When I was diagnosed with uterine fibroids, I wanted to find out everything I could about them. My symptoms were text book symptoms: heavy bleeding, a lot of pain, anemia. I was referred to a gynecologist, who recommended hysterectomy. Basically the story was,” Well you've had your children. You don't need your uterus anymore”. That just did not match my core belief about what my body was here for. I asked about alternative treatment, but was told that this was the only one available. I went on the internet to know more about treatment of fibroids. I discovered that embolization was the right treatment for me. I came in the morning... it was simple... as simple as it was explained to me. Within a week I was back at work. Within a couple of weeks I was running again. I love to run. When I think about friends who have had hysterectomies– whose lives were interrupted to weeks on end – and probably forever, their lives will be different. I'm just so happy about my decision."‐Ms. Mariam To see more such testimonials please get in touch with us. hospitalindia@gmail.com US/Canada Toll Free Number: 1‐888‐771‐6965 hospitalindia@yahoo.com International Helpline Number: 0091‐9899993637

Meet the Doctor Get a Free Expert Opinion from the Doctor Write to us at hospitalindia@gmail.com hospitalindia@yahoo.com Dr. Pradeep Muley M.D., Head & Senior Consultant Interventional Radiologist  Fellow Interventional Radiology. Singapore General Hospital, Singapore.  Visiting Associate, Neurointerventional Radiology, Iowa University Hospitals, USA  Visiting Fellow, Neurointerventional Radiology, Johns Hopkins Medical Institution, USA  Lecturer, Vascular & Interventional Radiology, KEM Hospital, Mumbai, India.  Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.  Consultant Interventional Radiologist, KIMS, Trivandrum, Kerala, India Department of Interventional Radiology was established by Dr. Pradeep Muley M.D. a graduate and M.D. from M.G.M Medical College, Indore, India and specialized in Body & Neurointerventional radiological procedures from Seth G.S. Medical College & K.E.M.Hospital, Mumbai India, All India Institute of Medical Sciences(AIIMS), New Delhi, India., John’s Hopkins Medical Institution, Baltimore, MD, USA, Iowa Hospitals and clinics, University of Iowa, Iowa City. USA and Singapore General Hospital, Singapore. He is assisted by a team of trained nurses and practicing radiologists and personally participates in all interventional procedures. A concern for the number of hysterectomies being unnecessarily performed and the disadvantages of myomectomy surgeries, Dr.Pradeep Muley became an active advocate for Uterine Artery Embolization for various causes like Fibroids, Adenomyosis, PPH, etc. He has performed more than 20,000 diagnostic & various interventional radiological procedures. Our Interventional Radiology Department has performed maximum number of uterine artery embolization in the country. Department of Interventional Radiology is specifically designed with facility of two well equipped & modern Cath‐labs for all diagnostic & Radiological interventional procedures (Vascular, nonvascular & image guided Interventions). Call us anytime to get in US/Canada Toll Free Number: 1‐888‐771‐6965 touch with the doctor International Helpline Number: 0091‐9899993637

Most Frequently Asked Questions Q. What are Uterine Fibroids? A. Uterine fibroids are noncancerous (benign) growths that develops in the muscular wall of the uterus and these are the most frequent tumours of the female genital tract.20 to 40% of women of childbearing age have a fibroid. Fibroids range in size from very tiny to the size of an orange or larger. In some cases, they can cause the uterus to grow to the size of a five‐month pregnancy or more. Fibroid may be located in various parts of the uterus. There are three primary types of uterine fibroids:  Subserosal fibroids, which develop in the outer portion of the uterus and expand outward. They typically do not affect women’s menstrual flow, but can become uncomfortable because of their size and the pressure they cause.  Intramural fibroids, which develop within the uterine wall and expand, making the uterus feel larger than normal. These are the most common fibroids. These can result in heavier menstrual flow and lower abdominal pain or pressure.  Submucosal fibroids are deep within the uterus, just under the lining of the uterine cavity. These are the least common fibroids, but they often cause symptoms, including very heavy and prolonged periods. Uterine Artery Embolization has many Indications:‐  Single / multiple Uterine Fibroids.  Adenomyosis.  Failed Myomectomy / recurrence of fibroids after Myomectomy  High risk patient for surgery like obesity, anaemia, chronic renal failure etc.  Post‐partum Haemorrhage  Bleeding from Cancer of Cervix & Uterus  Pre‐operative Embolization to reduce bleeding during uterine surgery. For more information and a Free Medical Opinion please get in touch with us hospitalindia@gmail.com US/Canada Toll Free Number: 1‐888‐771‐6965 hospitalindia@yahoo.com International Helpline Number: 0091‐9899993637

Q. What are typical symptoms? A. Depending on location, size and number of fibroids, they may cause: 1) Heavy, prolonged menstrual periods and unusual bleeding, sometime with clots. This might lead to anaemia. 2) Lower abdomen, back or leg pain 3) Lower abdomen pressures or heaviness 4) Bladder pressure leading to a constant urge to urinate 5) Pressure on bowel, leading to constipation and bloating 6) Abnormally enlarged abdomen Q. Who is most likely to have Uterine Fibroids? A. Uterine fibroids are very common, although, often they are very small and cause no problem. From 20 to 40 % of women aged 35 and older have uterine fibroids of a significant size. Q. How are uterine fibroids diagnosed? A. Fibroids are usually diagnosed during a gynaecologic examination. The presence of fibroids is most often confirmed by a lower abdomen ultrasound. Fibroids can also be confirmed using MRI (magnetic resonance imaging) and computed tomography (CT scan). Appropriate treatment depends on the size and location of the fibroids, as well as the severity of symptoms. Q. How are uterine fibroids treated? A. Treatment options for Uterine Fibroids: 1) Medical Management. 2) Minimally Invasive Therapy (Uterine artery or Fibroid Embolization) and 3) Surgical Management 1. Medical Management Effective medical therapy is not available for management of fibroids. However hormonal drugs in the form of injections have recently become available which are expensive (GnRH analogue) this hormonal therapy cannot be used for long term basis because of its side effects. Also rapid re‐growth of fibroids can occur when therapy is discontinued. 2. Minimally invasive therapy (Uterine‐sparing treatment / Uterine Artery (or fibroid) Embolization This minimally invasive procedure will be explored further in this brochure. Briefly, an interventional radiologist makes a tiny incision in the groin and passes a small tube called catheter through the artery. When the catheter reaches the uterine artery, the interventional radiologist slowly releases tiny particles, the size of grains of sand, into the vessels. The particles flow to the fibroids and wedge into the vessels and cannot travel to other parts of the body. This blocks the blood flow to the fibroids, causing it to shrink. 3. Myomectomy (Surgical option) Myomectomy is a surgical procedure that removes visible fibroids from the uterine wall. Myomectomy, like Uterine Artery Embolization for fibroids, leaves the uterus in place and may, therefore, preserve the women’s ability to have children. There are several way to perform Myomectomy, including Hysteroscopic Myomectomy, Laparoscopic Myomectomy and open abdominal Myomectomy. Hysteroscopic Myomectomy: It is used only for fibroids that are just under the lining of the uterus and that protrude into the uterine cavity. There is no need for surgical incision. The doctor inserts a flexible scope (hysteroscope) into the uterus through the vagina and cervix and removes the fibroids using surgical tools fitted to the scope. Usually this procedure is performed while the patient is under anaesthesia and not conscious. The hospital stay is about 2 days, the postoperative recovery period of two weeks, needs general anaesthesia, some time causes bleeding which may need blood transfusion and chances of infection are also there. Removal of big size fibroid is difficult which may need 2‐3 sittings. Laparoscopic Myomectomy: Laparoscopic Myomectomy may be used if the fibroid is on the outer wall of the uterus. Small incisions are made on the abdomen and then a probe is inserted with a tiny camera attached and another probe fitted with surgical instruments, into the abdominal cavity and tumour is removed piecemeal. It is performed while the patient is under general anaesthesia and not conscious. The average recovery time is about two weeks. Some time cause bleeding which may need blood transfusion and chances of infection may also be there.

Abdominal Myomectomy: This is an open abdominal surgery to remove fibroids. It needs 2‐3 incision on abdomen. Once the fibroids are removed, the uterus is stitched and closed. The patient is given general anaesthesia and not conscious for this procedure, the hospital stay is 4‐5 days and postoperative recovery period is six weeks. Sometimes procedure causes bleeding which may need blood transfusion, adhesions may cause problem. Re‐growth rate of fibroids is high. While Myomectomy is frequently successful in controlling symptoms, it is not successful in case of multiple fibroids. In addition, fibroids may grow back several months/years after Myomectomy Hysterectomy: In hysterectomy (Vaginal or Abdominal), the uterus is removed by an open surgical procedure. This operation is considered a major surgery and is performed while the patient is under general Anaesthesia. It requires four to five days of hospitalization and the average recovery period is about six weeks. Hysterectomy is the most common current therapy for women who have fibroid. It is typically performed in women who have completed their childbearing years or who understand that after the procedure, they cannot become pregnant. Q. What is Fibroid Embolization? A. It is a minimally invasive procedure, which means it requires only a tiny nick in the skin. It is performed while the patient is conscious but sedated – drowsy and feeling no pain. Fibroid Embolization is performed by an interventional radiologist, a physician who is specially trained to perform this and other minimally invasive procedures. The interventional radiologist makes a small nick in the skin (less then ¼ of an inch) in the groin and inserts a catheter into an artery. The catheter is guided through the artery to the uterus while the interventional radiologist guides the progress of the procedure using a moving X‐ray (fluoroscopy). The interventional radiologist injects tiny plastic particles the size of grains of sand into the artery that is supplying blood to the fibroid tumour. This cuts off the blood flow and causes the tumor (or tumors) to shrink. The artery on the other side of the uterus is then treated. Embolization preparation: A tiny angiographic catheter is inserted through a nick in the skin in to an artery and advanced into uterus. While Embolization to treat uterine fibroids has been performed since 1995, Embolization of the uterus is not new. It has been used successfully by interventional radiologist for over 20 years to treat heavy bleeding after childbirth. This procedure is now available at few hospitals. Q. Which patient can go for Fibroid Embolization? A. Ideal Patient for Uterine Artery Embolization. 1) They have single / multiple fibroids 2) The fibroids are symptomatic 3) There is no cancer (as suggested by pap smear or endometrial biopsy) Q. How successful is the Fibroid Embolization Procedure? A. Studies show that 78 to 94% of women who have the procedure experience significant or total relief of heavy bleeding, pain and other symptoms. The procedure also is effective for multiple fibroids. No re‐growth of treated fibroids is observed. Q. Are there risks associated with the treatment of fibroid tumors? A. Fibroid Embolization is considered a safe alternative to hysterectomy and Myomectomy. There are some associated risks, as there are with almost any medical procedure. Most women experience moderate pain and cramping in the first several hours following the Fibroid Embolization Procedure. Some experience nausea and fever. These symptoms can be controlled with antibiotics and pain medication. Less than 1% of the patients need Myomectomy or Hysterectomy to complete the removal of a persisting fibroid. Myomectomy and hysterectomy also carry risks, including infection, bleeding leads to blood transfusion. Patients who undergo Myomectomy may develop adhesions causing tissue and organs in abdomen to fuse together, which can lead to other problems. In addition, the recovery time is much longer for abdominal Myomectomy, generally one to two months. For more information and a Free Medical Opinion please get in touch with us hospitalindia@gmail.com US/Canada Toll Free Number: 1‐888‐771‐6965 hospitalindia@yahoo.com International Helpline Number: 0091‐9899993637

Treatment at a World‐Class Hospital for an Unbeatable Package of $4000 only What does the Package include? Our Package Cost includes the following services besides the cost of the medical treatment itself: (i) Internal transfers by AC Car to and from the Hospital to the International Airport on arrival/ departure. (ii) Initial consultation with the Surgeon/ Physician on arrival at the hospital. (iii) Standard pre‐surgery tests, including X‐rays, scans, as required. (iv) Standard pre / post surgery medication (v) Stay in an AC room for the number of days indicated against the package. One companion can also stay with the patient in this room,which is equipped with Colour TV, connected to Cable, and internet surfing facility. (vi) Our Guest relations officer provide priority facilitation to overseas patients during their stay at the hospital. (vii)A comprehensive written medical report before discharge (viii) A personal dietician who will advise the patient throughout the stay and advise F& B to serve from a special international menu of food and beverages for the patient. (ix) Post discharge consultation if required after patient's return to his home by email/ telecalling ( review of scans or X Rays,telephonic consultation, etc. ) (x) We accept International Master Visa Credit Card and provide Currency Exchange facility in the hospital. (xi) Travel, Tourism assistance, Air ticket reconfirmation, assistance, in case the patient wants to combine the treatment with a holiday or extended recuperation in India xii) Periodic E‐ mail updates to the referring doctors and the patients family. Note: This package cost does not include 1) Treatment of any unrelated illness or procedures other than the one for which this estimate has been prepared. 2) Expenses for any additional hospital stay beyond the stipulated days as per the estimate shall be payable extra. 3) The cost ranges provided are based upon our understanding that the patients is otherwise healthy and does not suffer from any medical complications .More informed estimates can be provided once the patient has been thoroughly examined by the concerned physician at treating institution. To get the lowest quote please get in touch with us hospitalindia@gmail.com US/Canada Toll Free Number: 1‐888‐771‐6965 hospitalindia@yahoo.com International Helpline Number: 0091‐9899993637

How to get started? Centre for Fibroids Treatment at New Delhi,India has an Interventional Radiology Department that specialises in Non Surgical Treatment of Fibroids, Adenomyosis and Endometriosis without the surgical treatments like Hysterectomy and Mymectomy. Interventional Radiology Department is specifically designed with facility of two well equipped & modern Cath‐labs for all diagnostic & Radiological interventional procedures (Vascular, nonvascular & image guided Interventions). How to get started? It is very simple. Just send us the following,  Please send information regarding patient’s Symptoms , Age and past Medical History  Radiological investigations like Ultra‐sonography / CT/ MRI, biopsy reports (If any)  For fibroid treatment, in addition, send reports of pap smear / endometrial biopsies (If available) To the following e‐mail ids hospitalindia@gmail.com hospitalindia@yahoo.com In case you do not receive any response within 48 hours of sending the Query/Reports then please call us at our International Helpline Number: 00919899993637 US/Canada Toll Free Number: 1‐888‐771‐6965 • You will get a response from us based on the information sent by you within 48 hours . • We will answer any additional questions you may have. • If the response provided by us is acceptable to you then you can decide to come to us for the treatment. • Get a valid passport if you do not have one. (If you need any help in getting the passport then please contact us.) • Get a valid Indian Visa. (If you need any help in getting the Indian Visa then please contact us.) • Get your air tickets done. (If you need any help in getting the tickets then please contact us.) • Send us your arrival details (arrival date, arrival time, flight number and flight name) atleast 10 days in advance so that we can do the necessary bookings for you. • On the day of your arrival we will make pick‐up arrangement for you from the airport. Please feel free to contact us anytime for any information or help.

Non surgical Fibroids Treatment

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