Oct

Oct. 13, 2004, 10:54PM

Easier way to eliminate fibroids

New procedure for growths can spare the uterus

By PATRICK KURP

Janet Holt was strapped to a gurney with an IV stuck in her arm, headed for the operating room where a surgeon was waiting to perform her hysterectomy, when an anesthesiologist noticed the elevated blood-sugar level recorded on her charts. The risks were too high, he announced. The operation was off, and Holt was stuck with the frequent, heavy menstrual bleeding she had lived with for years. The fibroids in her uterus, one estimated at the size of a 5-month-old fetus, would, for now, stay where they were. Only later, when her husband, a news editor for a Houston television station, read a story about a new, nonsurgical procedure for removing uterine fibroids, would Holt get a second chance, despite her diabetes. Thanks to uterine fibroid embolization, she is now fibroid-free, has a normal menstrual cycle and retains her uterus. "Now I don't even think about it anymore. It's like having a new life," said the 47-year-old speech pathologist and mother of two from Sugar Land.

Fibroid symptoms

Fibroids are masses of fibrous and muscle tissue in the wall of the uterus. They are noncancerous but often cause heavy menstrual bleeding, pelvic pain, or pressure on the bladder or bowel. Infertility and miscarriages can also result. At least 25 percent of women in the United States have clinically symptomatic fibroids, according to the National Institutes of Health, and other estimates are significantly higher. Until recently, treatment for most cases of uterine fibroids was limited to pain medication, hormones, myomectomy (surgical removal of the fibroids) and hysterectomy (removal of the uterus). In the early 1990s, a team of French physicians pioneered a new, less invasive procedure that results in faster recoveries. "This way, you can avoid a big surgery with a long recovery time. The incisions are smaller, and there's much less risk of blood loss. It's all part of the trend toward less invasiveness," said Dr. Lucho Rossman, a vascular and interventional radiologist at the University of Texas Medical School in Houston, where Holt had her procedure performed. The patient remains conscious. Using a procedure similar to heart catherization, the radiologist makes a quarter-inch incision on the upper thigh and feeds a thin tube through the femoral artery and into the uterine arteries. Small particles are injected, causing a blockage of the arteries feeding the fibroids. In effect, the fibroids are starved.

Immediate relief

The procedure was first used on patients as a means of decreasing blood loss during myomectomy, but it was discovered that embolization alone was often enough to eliminate symptoms. Patients often experience immediate relief, but the fibroids continue to shrink for six months or more. "I went in on a Wednesday, came home on Friday and went back to work the following Monday," Holt said. "It was wonderful."

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