Uterine Artery Embolization

By now you might have heard that the nominee for U.S. secretary of state, Dr. Condoleezza Rice, a black woman, will undergo uterine artery embolization (UAE). UAE, a minimally invasive surgical procedure, is used in this instance as a treatment for uterine fibroids.

Why is Dr. Rice's race significant? Because black women have a three-to-five times greater risk than white women of developing fibroids.

So, what are uterine fibroids? Briefly, the wall of the uterus is made up of several tissue layers. Most of the thickness is taken up by muscle tissue called myometrium (myo means muscle, metrium means uterus). Sometimes this muscle layer starts to grow in knots instead of orderly sheets. These knots are commonly known as fibroids.

Most fibroids are noncancerous; some can grow [WARNING, graphic picture] very large, and they can cause pain, heavy bleeding, infertility, problems with urination and defecation, etc. Incidentally, fibroids are a leading indication for surgery to remove the uterus (hysterectomy) in women of childbearing age.

The medical name for fibroids is leiomyomas; some other names you might hear used are myomas, fibromyomas, fibroleiomyomas, or fibromas.

An interesting aside. Menstrual management can help women with fibroids by reducing the heavy/prolonged bleeding they experience. The role of the birth control pill in lowering a woman's risk of fibroids isn't clear--one study found a 31% risk reduction in women who had used the Pill for ten years. What is clear is that overall, if you have fibroids, using the Pill does not increase their size. This is important for you to remember because there are health professionals who think a history of fibroids is a contraindication to using the Pill. It isn't.

Back to uterine fibroid embolization, the procedure uses techniques similar to those used in heart catheterization. A needle is inserted into the femoral artery near the groin, and a catheter is guided into the uterine artery. Once in place, tiny particles of polyvinyl alcohol, about the size of grains of sand, are injected under X-ray guidance.



The particles flow to the fibroid and block its blood flow. Deprived of blood supply the fibroid shrinks, relieving symptoms.