Surgery not always needed for fibroid relief

By Latha Erickson
CNN

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(CNN) -- As many as one in four women older than 35 have uterine fibroids, says the American College of Obstetricians and Gynecologists.

Fibroids are non-cancerous tumors made of muscle cells and other tissues that grow in and around the wall of the uterus. No one really knows what causes them, but they can occur at any age.

Alecia Hooks of Atlanta, Georgia, lived with fibroids for 10 years. She initially chose not to treat them because, like many women, she had no symptoms. But at age 41, Hooks started experiencing pain.

"I had an increase in pressure in that area and also a lot of leg pain and also I became anemic," she recalls.

Her gynecologist found that Hooks' uterus was the size of a woman's who was 26 weeks pregnant. The doctor recommended a partial or complete hysterectomy.

Hysterectomies were once the obvious choice for treating conditions such as fibroids, excessive bleeding and endometriosis. Dr. Nicholas Fallieras, an obstetrician and gynecologist in Tampa, Florida, says women now have options. (Endometrial ablation is one alternative to hysterectomy. )

"Years ago, for example, if someone had some bleeding problem and they had a fibroid, that was almost a ticket to the operating room," he says. "Nowadays we use hormonal manipulation. Women are more sophisticated as far as their care, and most people are reluctant to go to the operating room unless they have good reason."

Hooks was one who wanted to avoid a hysterectomy.

"I thought, 'You know I am still young,' she says. 'I don't want to have major surgery.' " She is on medication for hypertension, and she worried that after a hysterectomy she'd need hormone replacement therapy.

"It just was not an option for me."

She elected to try uterine fibroid embolization, or UFE. UFE is a common alternative to a hysterectomy. A catheter is placed in each of the two uterine arteries and small particles are injected to block the arterial branches that supply blood to the fibroids. The fibroid tissue dies, the masses shrink, and in most cases symptoms are relieved.

Because UFE is an outpatient procedure, it requires a much shorter recovery time and usually is less painful.

A hysterectomy has a recovery time of four to six weeks, but UFE allows women to be back on their feet in about two weeks. With no incision, there's less pain, Fallieras says.

"These women ... can get up and move because they don't have incisional pain," he says. "They do have abdominal pain but it's shorter-lived than what you would go through with a hysterectomy.

Within 48 hours of her procedure, Hooks says, she was better than her old self. She was back at work after 10 days. She felt great, she was more active and had more energy.

Hooks doesn't have children right now, but uterine fibroid embolization allows her to keep that door open down the line.

"I think this is a wonderful option, and I wish I had done it so much sooner," she says. "I am so glad I did it and I have so much relief now."

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