Uterine fibroids are benign tumors that develop in the wall of the uterus. They are most common in women in their 30s and 40s. Symptoms include heavy bleeding, pain, and pressure. Diagnosis involves pelvic exam, ultrasound, or MRI. Treatment options include medication, myomectomy (surgical removal), uterine fibroid embolization (blocking the blood supply), and hysterectomy (removal of the uterus). Uterine fibroid embolization is a minimally invasive treatment performed by interventional radiologists, involving blocking the blood vessels supplying the fibroids.

1. What are Uterine Fibroids? Benign (Noncancerous) tumors that develop in the wall of the uterus Can cause problems because of their size and location Typically improve after menopause Can grow in different places in the uterus Typically improve after menopause MR09-001 Rev. B

2. What are Uterine Fibroids? Benign tumor of uterine smooth muscle Fibroids are not considered to be pre-cancerous Also referred to as myomas or leiomyomas Types: submucosal, intramural, and subserosal

3. What are Uterine Fibroids?

4. What are Uterine Fibroids?

6. Fibroids linked to estrogen

7. Evidence that progesterone may stimulate fibroid growth

9. Fibroids most frequently diagnosed in 30s & 40s

10. Most common tumor of the pelvis in females

12. 20% of women in their 20’s

13. 40% of women in their 40’s

14. Genetic predisposition

15. African-American women at higher risk

16. Familial tendencies

18. Pain, pressure, or feeling of fullness in the pelvis, abdomen, or lower back

19. Frequent urination or constipation

20. Pain during or bleeding after intercourse

21. Infertility or miscarriage

22. Abnormally enlarged abdomen

26. Fibroids also can be confirmed using magnetic resonance (MR) and computed tomography (CT) imaging techniques

29. When they do cause symptoms, drug therapy often is the first step in the treatment

31. Some hormone therapies do have side effects and other risks when used long-term so they are generally used temporarily

34. Hysterectomy

35. Endometrial Ablation

36. MR-guided Ultrasound

39. Only part of uterus is treated and recurrence can occur; 15 to 25 % need repeat procedure

43. It can be done on an outpatient basis or even in a doctor's office.

45. Will not reduce symptoms related to fibroid bulk

46. Addresses only bleeding symptoms, does not treat the fibroids

47. Abnormal uterine bleeding may recur, requiring additional procedures

50. One to two day recovery with minimal discomfort

53. Treats only one fibroid at a time

54. Usually only appropriate for small fibroids near the surface of the uterus

55. Insurance may not cover this procedure

57. No risk of future fibroids

59. Loss of child bearing potential

60. General anesthesia

61. 2 days to 6 weeks recovery time

62. Hormonal changes (if ovaries are removed)

63. Long term side effects have been reported

64. Emotional

66. Over 600,000 hysterectomies per year

67. 40,000 myomectomies, 25,000 UFE

68. 2nd most frequent surgical procedure in women of reproductive ages (after C-section)

69. 90% for benign reasons

70. 35% for fibroids

71. 20% of women by age 40

72. 33% of women by the age of 65

74. Avoid surgical adverse events

75. Pelvic support issues

76. Bladder dysfunction

77. Menopause & HRT

78. Hospitalization, recovery

79. Sexual Dysfunction

80. Save uterus because

81. Source of femininity

82. Fertility

83. Self image

86. The interventional radiologist makes a small nick in the skin (less than 1⁄4 of an inch) in the groin and inserts a catheter into an artery.

87. The catheter is guided through the artery to the uterus while the interventional radiologist watches the progress of the procedure using a moving X-ray (fluoroscopy).

88. The interventional radiologist injects tiny plastic particles the size of grains of sand into the artery that is supplying blood to the fibroid tumor.

90. Angiography Suite, like an OR with a modern X-ray machine, sterile conditions

91. Epidural anesthesia or conscious sedation

92. Procedure typically takes one hour to complete

94. Fever is an occasional side effect, and is usually treated with acetaminophen - Starts a few hours after the procedure and may last 3 to 5 days

96. The procedure is effective for multiple fibroids

98. How are Uterine Fibroids Treated? Uterine Fibroid Embolization Mechanism of Action Embospheres

101. Up to 2% of procedures technically unsuccessful

102. Pelvic pain or cramping after procedure can remain moderate to severe for several days

103. 1% to 2% chance of serious complication i.e. hysterectomy

106. Results

107. Friday, November 19, 2004 Posted: 4:07 PM EST (2107 GMT)

108. WASHINGTON (CNN) -- National security adviser Condoleezza Rice, President Bush's nominee to be the next secretary of state, is doing well after successful surgery, Jim Wilkinson, deputy national security advisor, told CNN Friday

109. Rice 'resting comfortably' after surgery

110. Expected to return to work on Monday