Uterine Fibroid Embolization – ‘Surgery Without A Knife’


By Dr Ravjit Sagoo, Interventional Radiologist and Dr Timona Obura, Obstetrician Gynaecologist and Laparoscopic Surgeon at Aga Khan University Hospital, Nairobi

Treatment for uterine fibroids has for long been associated with surgery, painting a painful and long recovery periods, and making many women suffering from the condition dread undergoing the procedures. However, technological developments in the medical field across the globe have broken new ground and given rise to sophisticated non-invasive treatment for fibroids.

These developments in healthcare technology have given birth to Uterine Fibroid Embolization (UFE) a less invasive, safe and effective treatment for fibroids. UFE is a global treatment of the fibroids regardless of size, number, or location. It is a painless, image-guided procedure and has been performed to many patients locally at Aga Khan University Hospital, Nairobi (AKUH). The main benefits for women are that the ‘cut’ is only 2mm and they can return to work within a week of the procedure. This mode of treatment has increased treatment options for women suffering from these growths.

Fibroids are noncancerous, abnormal growths that develop in, or on a woman’s uterus during their reproductive years.  Research indicates about 80 percent of women develop fibroids by the time they get to the age of 50. African women compared to Caucasian are likely to be diagnosed with these tumors.  It is unclear what causes them.

Women suffer from different types of fibroids as this is diagnosed through the location in the uterus.  For an accurate finding as to which type of fibroid a woman is suffering from, a patient needs to see a gynecologist and get her a pelvis examined. This checkup is used to identify the condition, size, and shape of a patient’s uterus. Other tests may include ultrasound and MRI for conclusive results. Therefore, treatment is administered based on patient’s age, size of the growths and overall health.

UFE is carried out by an interventional radiologist who inserts a tiny tube a 2mm ‘cut’ at the top of the leg or in the wrist, maneuvering it through the uterine artery, and injecting tiny particles into the arteries that supply blood to the uterus and fibroids. The particles ultimately block the blood supply to the fibroids, causing them to die and shrink. During the procedure, the specialist uses a high-definition x-ray camera to guide him, or her to introduce a catheter into the uterine arteries to deliver the particles. This is performed to a patient in a catheterisation laboratory (located on the third floor of the Heart and Cancer Centre at AKUH).

As the fibroids die and begin to shrink, the uterus fully recovers. During the UFE procedure the uterus is not affected as tolerates embolization very well. The particles enter the fibroids, as their blood vessels are larger and have lower resistance to flow, therefore it cannot be absorbed to other parts of the body. A successful UFE procedure treats all fibroids that are present on the day of the procedure, regardless of size, number, or location. With UFE patients ordinarily can resume their usual activities much earlier than if they had surgery in order to treat their fibroids (typically within 1 week).

It is safe for women who want to conceive after undergoing a UFE procedure though it is advised to wait for between six to twelve months before attempting to conceive.