Uterine fibroid is a tumor that develops from the muscle fibers and connective tissue of the uterus. According to recent studies, its appearance and development depend on the state of the immune and hormonal systems of the female body. At the same time, uterine fibroid does not contain cancer cells and is a benign tumor that can be successfully treated.
Uterine fibroid is diagnosed in 25 – 30% of women over the age of 35, and among 45-year-olds – in 50-62% of cases. During preventive gynecological examinations, the tumor is first detected in 1–5% of women. Uterine fibroids can be of different sizes: from a very small tumor, which can only be determined on an X-ray of the uterus, to a large tumor that weighs about a kilogram and is easily palpable through the abdominal wall. Sometimes several uterine fibroids can be located in different places of the uterus, and each of them develops in its own way.
Uterine fibroids are rare in women before puberty, as well as in women after menopause. Most studies confirm the fact that the development of fibroids is associated with hormonal disorders in the female body, including increased levels of estrogen. Under the influence of this hormone, the synthesis of muscle fibers of the uterus increases, while the growth rate of endometrial cells also increases. However, uterine fibroids also occur in women with a normal menstrual cycle, that is, without hormonal disorders.
Women need to know that at the onset of the disease, uterine fibroids practically do not manifest themselves. It can be detected only with a periodic preventive examination by a doctor, specified in obstetrics and gynecology.
As uterine fibroids develop, alarming symptoms begin to appear which a woman should pay attention to and schedule a consultation with a doctor. First, you should be alerted to the increase in the intensity of menstrual flow and the very duration of menstruation.
Heavy menstrual bleeding (menorrhagia) is the most common symptom of uterine fibroids. Bleeding gradually increases, this in many cases can lead to anemia (a decrease in the amount of hemoglobin in the blood). Pain with uterine fibroids occurs in cases of a complicated course of the disease: with twisting of the fibroid or necrosis of the uterine fibroid node.
Bleeding becomes more and more profuse over time, and many women begin to take it as a norm, although they should immediately contact a doctor. The danger of menorrhagia is that it can lead to anemia. An increase in the number of menstrual flow indicates that due to uterine fibroids, the muscles of the uterus are contracting harder. On the background of menorrhagia, there may be another alarming symptom of uterine fibroids – acyclic ("extraordinary") uterine bleeding or an untimely period.
With menorrhagia, it is not the tumor itself that bleeds, but the mucous membrane of the uterus due to the proximity to the tumor. Along with bleeding, uterine fibroids are characterized by pain, and its nature can be very different. It is usually concentrated in the lower abdomen and lumbar region. When the disease reaches the stage of circulatory disorders, the pain becomes sharp and sudden. With a large tumor and its slow growth, women experience an aching pulling pain usually throughout the entire menstrual cycle. Cramping pains occur when the tumor grows in the lining of the uterus. With the development of uterine fibroids, the work of neighboring organs – the bladder and rectum – is disrupted.
If the uterine fibroid grows in the direction of these organs, the patient has a feeling of compression of the bladder; urination becomes difficult and frequent. Chronic constipation associated with fibroid pressure and rectal compression becomes common. Uterine fibroid pressure on the bladder or rectum causes dysfunction of these organs. Sometimes the nutrition of the fibroid node worsens, which can lead to its necrosis. This is accompanied by a feeling of fatigue, fever, and severe pain.
Diagnosis of uterine fibroids is quite simple. When the disease has reached a certain stage, it is possible to establish a diagnosis with the help of a routine gynecological examination, in which it is easy to identify an enlarged uterus of dense consistency, often having a bumpy surface. In some cases, especially if a woman complains of heavy menstrual bleeding, an ultrasound examination of the pelvic organs is required to clarify the diagnosis. The condition of the lymph nodes can be established using hysteroscopy. However, the referral for hysteroscopy is not given to all patients, since this medical procedure has some contraindications and must be performed under intravenous anesthesia.
Medical methods for uterine fibroids diagnosis include:
- Ultrasound of the pelvis
- Magnetic resonance imaging
Almost every woman can undergo uterine fibroid embolization (uterine artery embolization), regardless of the size of the tumor and the number of nodes. There are cases in which uterine fibroid embolization is the only method of effective treatment of uterine fibroids with minimal consequences, for example, in case of relapses after myomectomy – the procedure of removal of myomatous nodes. Uterine fibroid embolization is indicated in a situation where there are many nodes and they are located in areas that are difficult to access with surgical intervention. The uterine fibroid embolization procedure is also allowed for patients with heart disease and respiratory failure, who are contraindicated for abdominal surgery.
The indications for uterine fibroid embolization of the arteries are, first of all, the desire to preserve the uterus, the possibility of avoiding surgical procedures to remove it, and the patient’s interest in pregnancy.
Contraindications for uterine fibroid embolization are:
- The presence of uterine fibroid for more than 20 weeks of pregnancy with multiple nodes
- Subserous uterine fibroids
- Contraindications to angiography: severe anaphylactic reactions to X-ray contrast agents
- Borderline and malignant processes in the reproductive system
- Previous radiation therapy of the pelvic organs
- Anomalies of the iliac vessels
Uterine artery embolization is a method that allows doctors to treat a benign tumor without active surgical intervention, preserving the patient's fully functioning uterus, the ability to become pregnant and carry a child. The essence of the uterine artery embolization is in the overlap of the uterine arteries, which leads to a cessation of the supply of myomatous nodes and their independent death.
The uterine arteries are the main source of blood supply to the uterus. They carry the greatest volume of blood, which is supplemented by secondary arteries. This happens in healthy myometrium.
When treating fibroids by uterine artery embolization, special balls of a strictly defined size are injected into the arteries – emboli. They close the lumens in the vessels, blocking the flow of blood to the tumor. In this case, the doctor does not have to "approach" each node separately.
Very quickly, the emboli are closed with fibrin fibers and thrombotic masses so that they cannot budge. The artery is reliably occluded. The lack of blood supply gives rise to the process of replacing the node with connective tissue – fibrosis. The nodes decrease on average 2 times without the possibility of re-growth. Connective tissue remains, which does not pose a threat to the patient’s health. The nodes growing into the uterine cavity gradually lose connection with it.
A small number of emboli may also appear in the vessels supplying the uterus, but this will not affect the patient’s health. Due to the branched circulatory network, emboli will be rapidly washed out from healthy areas. A small part will collapse naturally.
Uterine artery embolization is performed by an endovascular surgeon. The uterine artery embolization procedure does not require general anesthesia, since the vessels have no nerve endings. The emboli itself is also painless, so local anesthesia at the puncture site is sufficient. To avoid infectious, complications, and the development of inflammation, the patient is administered antibiotics for 5 days before the uterine artery embolization procedure and 5 days after.
A thin catheter is inserted through a puncture in the groin into the femoral artery, which is then inserted into both uterine arteries. It is important to place the catheter so that the emboli enter the arteries of the myomatous nodes. First, an iodine-based contrast agent is injected through the catheter and an X-ray is taken. This allows the technician to verify that the catheter has reached the desired location. For a moment, the patient may feel warmth in the lower abdomen. Then a suspension with emboli is injected through the catheter. Control angiography completes the uterine artery embolization. After making sure that the fibroid is bled, the surgeon removes the catheter from the artery. The puncture site is closed with a special device.
The total duration of the uterine artery embolization procedure depends on the doctor's experience – on average, it is 10-15 minutes. Then the patient is transferred to the care unit, where undergoes anesthetic therapy. As early as 2.5 hours after the uterine artery embolization, the patient can bend the legs, after 6–7 hours get out of bed, and eat.
Despite the seeming simplicity, uterine artery embolization is a technically complex procedure that requires a surgeon to be highly qualified and narrow professional knowledge, including in the field of X-ray anatomy of the uterus and pelvic organs, attentiveness, and high accuracy. This largely determines the success of uterine artery embolization and the risk of negative consequences of the procedure.
No additional procedures are required after uterine artery embolization. It allows achieving complete replacement of myomatous nodes with connective tissue, defeats negative symptoms, normalizes the genitourinary system, and restore a woman's reproductive function.
Where can I undergo treatment with uterine artery embolization abroad?
Health tourism becomes more and more popular these days, as medicine abroad, often ensures a much better quality of treatment with uterine artery embolization.
The following hospitals show the best success rates in treatment with uterine artery embolization:
- University Hospital Rechts der Isar Munich, Germany
- University Hospital Tuebingen, Germany
- Memorial Sisli Hospital Istanbul, Turkey
- Medicana International Hospital Istanbul, Turkey
- Leverkusen Clinic, Germany
You can find more information about the hospitals on the Booking Health website.
The cost of treatment with uterine artery embolization
The prices in hospitals listed on Booking Health are relatively low. With Booking Health, you can undergo treatment by uterine artery embolization at an affordable price.
The cost of treatment varies, as the price depends on the hospital, the specifics of the disease, and the complexity of its treatment.
The cost of treatment with uterine artery embolization in Germany is 15,617 – 26,603 EUR.
The cost of treatment with uterine artery embolization in Turkey is 10,782 – 11,202 EUR.
You might want to consider the cost of possible additional procedures and follow-up care. Therefore, the ultimate cost of treatment may differ from the initial price.
To make sure that the overall cost of treatment is suitable for you, contact us by leaving the request on the Booking Health website.
How can I undergo uterine artery embolization abroad?
It is not easy to self-organize any treatment abroad. It takes certain knowledge and expertise. Thus, it is safer, easier, and less stressful to use the services of a medical tourism agency.
As the largest and most transparent medical tourism agency in the world, Booking Health has up-to-date information about uterine artery embolization in the best hospitals in the world. We will help you select the right clinic taking into account your wishes for treatment.
We want to help you and take on all the troubles. You can be free of unnecessary stress, while Booking Health takes care of all organizational issues regarding the treatment. Our services aimed at you safely and successfully undergoing treatment with uterine artery embolization.
Medical tourism can be easy!
All you need to do is to leave a request on the Booking Health website and our manager will contact you shortly.