Debra Stockard wasn't the type to run to the doctor for every little ache and pain. But after years of suffering from heavy bleeding during painful periods and a host of other discomforts, she relented and then received a diagnosis: uterine fibroids. Another seven years later, she finally waved the white flag.
Rejecting the options given at diagnosis — hysterectomy or drug treatment — Stockard tried valiantly for years to manage her condition with diet and vitamins, exercise and sheer willpower. Earlier this year, she contacted Mallinckrodt Institute of Radiology to schedule a consultation after reading online about uterine fibroid embolization (UFE).
In May, Stockard underwent UFE at Barnes-Jewish Hospital. Performed by Mallinckrodt Institute of Radiology interventional radiologist Seung Kwon Kim, MD, the hour-long procedure eliminated the worst of her symptoms and launched a recovery that has vastly improved her quality of life.
What is UFE?
UFE isn’t new; in fact, the procedure has been available for more than two decades and offered at Mallinckrodt since the early 1990s. Yet this very effective, minimally invasive alternative for treating fibroids seemingly remains under the radar of patients and some gynecologists.
Uterine fibroids are muscular tumors that grow on and in the walls of the uterus. Although their exact origin remains unknown, hormones are the likely culprit as fibroids tend to grow rapidly during pregnancy, when hormone levels are high, and shrink once a woman reaches menopause and hormones are diminishing. A family history of fibroids is a known risk, as are obesity, eating a lot of red meat and ham, and age (fibroids are most common in women from age 30 through menopause). In rare cases, fibroids can become cancerous.
The size and number of fibroids in any one individual can vary greatly. And although it’s estimated that as many as 80 percent of women develop fibroids by age 50, most do not experience any accompanying symptoms. But for women who do have symptoms, fibroids can be very hard to live with.
That was certainly the case for Stockard, who had most of the condition’s classic features — the aforementioned heavy bleeding and painful periods causing anemia, frequent urination, lower back and leg pain, and abdominal bloating and constipation.
Traditional vs. new treatment
The only complete cure for fibroids is to remove the uterus via hysterectomy. For women who wish to have children, this is not a viable option, and other alternatives exist. But many older women and women who don’t plan to have children also do not want to undergo a major surgery. UFE — with 90 percent symptom relief within 12 months and fewer complications and minimal blood loss compared to hysterectomy — is a cost-effective and ideal solution.
While under local anesthetic, a catheter is passed into an artery in the patient’s groin and threaded into the uterine arteries, releasing tiny gel or plastic particles that lodge in the arterioles feeding the fibroids and uterus. The uterus recovers quickly from the ensuing loss of blood by drawing on other vessels, but the fibroids essentially “starve.” They become soft and spongy, taking pressure off adjacent organs, and shrink over time — often 50 percent or more.
The benefits of UFE are fairly straightforward: minimally invasive versus major surgery, one week of missed work versus six, and in many cases, near-immediate pain relief. In the majority of cases, fibroids do not grow back.
At Mallinckrodt, interventional radiologists perform about 50 UFEs annually, says clinical nursing supervisor Lynn R. Hoese, RN. Many of the cases, she adds, are self-referred: People hear the options provided by their gynecologists, and then begin an Internet search to see if anything else can be done.
That’s exactly what happened for Stockard. Unwilling to go the hysterectomy route and not wanting to take a drug, she began researching her options. “I started seeing billboards about UFE,” she says. “Online, I read as many cases and blogs as I could find, really trying to gain a better understanding of what fibroids were and what might be helpful.”
Stockard remembers little of the procedure itself. She spent one night in the hospital — although the procedure can be done on an outpatient basis — and had some pain and mild nausea afterward, likely caused by anesthesia. The UFE left just a small incision scar in her groin.
“I returned to work one week later,” says Stockard, the mother of three and a moving company receptionist, though she admits that she tired easily at first and likely should have taken an additional week to recover. “After a couple of weeks it started to turn around. My first period was almost back to normal, without serious cramping; it was dramatically better.”
Nearly six months later, Stockard’s anemia is gone, and she’s gradually getting back to normal daily activities. An avid gardener, she looks forward to bringing her yard back to showcase status in the coming years. That’s what she wants people to understand about fibroids: Severe cases can truly impede quality of life.
“I’m glad I did it,” says Stockard. “Fibroids really affected me emotionally, as well as physically, and I was grateful this alternative to hysterectomy existed.”
Patient consultations are conducted at Mallinckrodt Institute of Radiology at Washington University Medical Center. Procedure locations include Barnes-Jewish Hospital and Barnes-Jewish West County Hospital. For patient scheduling or to talk with a nurse coordinator about UFE, please call 314-362-2375.