SYNOPSIS OF THE
PROCEDURE
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On February 4,
1998, Dr. Carlos Forcade's Radiology Unit
became the fifth medical
facility, and the second community hospital, in the country to
perform uterine artery embolization for the treatment of uterine
fibroids. Carlos
Forcade, M.D.,
Interventional
Radiologist, successfully treated a 23-year-old woman suffering
from multiple fibroids with this non-surgical outpatient procedure
that was performed under epidural anesthesia in just over one
hour.
At least one-quarter
of all women develop fibroids—benign uterine growths that
are usually symptomless but can cause excess menstrual bleeding,
pain, heaviness and discomfort. Most fibroids don't require treatment;
however, when bleeding or other symptoms become severe, a woman
may choose to have them removed.
The procedures
most often used to treat fibroids are: myomectomy (surgical
removal which can be associated with complications), myolysis
(destruction of fibroids through needle puncture/electrical
current, which can weaken the uterine wall) or hormonal therapy
(which shrinks fibroids only until about 1-1/2 months after
treatment ceases). If these treatments are not possible or
fail to eliminate the fibroids, the patient will typically have
her uterus removed through hysterectomy, which is considered
major surgery with a recovery period of as long as two weeks.
Arterial embolization
of the fibroid uterus is a simpler and safer procedure for the
elimination of fibroids. Interventional radiologists have been
performing embolizations on other parts of the body for over
20 years, but using the technique to treat uterine fibroids is
new in the U.S. The procedure has been done in France for approximately
8 years. In this country, the majority of uterine artery embolizations
have taken place at two teaching hospitals--UCLA Medical Center
in Los Angeles and Roxborough Memorial Hospital in Philadelphia.
A September 1999
survey by the SCVIR (Society of Cardio-vascular and Interventional
Radiology) of its membership for the FDA, the procedure has
been performed on 4165 patients in the US with 0 deaths, and
25 complications resulting in additional surgery within 30 days
of the procedure, a rate of less than 1%. Other sources suggest
that the world-wide total estimate at the same time probably
exceeds 8000.
Dr. Forcade stresses
that he will treat a patient only after she has been examined
and cleared for the procedure by a gynecologist. A typical procedure
is as follows: An anesthesiologist administers an epidural block.
A quarter-inch incision is made in the groin. A catheter is placed
into the artery that supplies blood to the fibroid and is guided
to the uterus. Poly vinyl alcohol, which consists of small plastic
beads the size of a grain of sand, is injected into the artery,
and blood flow to the fibroids is cut off, or embolized. The
patient stays in a hospital room for the next 23 hours, where
she is kept comfortable by the continuing effects of the epidural.
Discharge occurs the following morning.
The patient can
expect improvement almost immediately with respect to heavy bleeding
and pelvic pain. Within six weeks, the lack of blood supply will
cause the fibroids to shrink dramatically while the uterus remains
unharmed. (Later, visit our How
Embolization works page. At the end of the discussion you will
have the opportunity to see actual MRI pictures which show the
actual changes which followed embolization.)
Site of the
Month
01/01/2000 Our site was named "Site of the Month - January
2000" by
the Ob/GYN section of About.com, a health site with extensive
information analyzed first by experts in various fields.
National TV
11/12/98 The AARP filmed two
cases of Fibroid
Embolization
in Dr. Forcade's Radiology Unit for the purpose of a release on National
Television to educate the public on the technique.
Interviews were held with the patients, as well as Dr. Forcade
and Staff Gynecologist, Stephen Carolan, MD.
Inquiries
Inquiries regarding
uterine artery embolization at Northern Westchester Hospital may be directed
to the Program Coordinator, by calling the Hospital at
(888) 666-2002
from 8AM to 5PM (M-F EST).
Another
Gynecologic Service available through the Center is
Tubal Recanalization.
©
1998 Carlos
Forcade, MD
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