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Johns Hopkins Health - Power to Choose

Winter 2011
Issue No. 11

Power to Choose

Date: January 20, 2011

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Options for women with fibroids

Uterine fibroids, or noncancerous tumors in the uterus, can negatively affect your quality of life, resulting in heavy bleeding, prolonged menstruation or bleeding between periods.

What’s even worse is the idea that the only way to correct the problem is through hysterectomy. Although it’s true that hysterectomy offers the only permanent solution for fibroids, there are other options. Through the collaboration of gynecologist Catherine Sewell, M.D., M.P.H., and interventional radiologist Kelvin Hong, M.D., at the Johns Hopkins Fibroid Center, it’s easier than ever to review and customize your treatment options in a single doctor’s visit.

Among the less-invasive treatment possibilities are uterine artery embolization, or UAE, during which tiny pellets injected through the groin block blood flow to fibroid-feeding arteries, and MRI-guided focused ultrasound, in which high-frequency ultrasound waves target and kill fibroid tissue. Sewell says the best candidates for these procedures are women who have completed childbearing or are not interested in having children. And because neither procedure involves major surgery, many patients can go back to their normal routines quickly—as soon as one day after MRI treatment and about a week after UAE.

“The overall success rate for UAE is 80 percent,” Sewell says, “and women have satisfactory reduction in symptoms.” The success rate is slightly lower for MRI-guided focused ultrasound, at 70 percent. Also, the fibroids may grow back, but because most patients receiving treatment are in their 40s and close to menopause, regrowth isn’t a major issue.

“Gynecology and radiology have generally been operating in different silos rather than working together,” says Hong, who points out that the Johns Hopkins Fibroid Center brings the two disciplines together to create more diverse treatment options. Patients can visit with Sewell and Hong at the same time.

“That bridges most of the treatment options available,” Hong adds. “You can have all your questions answered in one go.”

Fibroid Facts

  • Three out of four women will have uterine fibroids, which are noncancerous tumors that grow in the uterus.
  • Symptoms may include heavy menstrual bleeding or unusually long periods, pelvic discomfort or pain, constipation, backache, or frequent or difficult urination.
  • Because most women experience no symptoms, they may not even be aware they have fibroids.
  • Uterine fibroids are not life-threatening and only require treatment if they’re causing unpleasant symptoms.

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