Optimal Results Achieved Through Minimally Invasive Uterine Fibroid Embolisation Procedure
Wednesday, 20 November 2013 Although it is not widely known, a very effective, minimally invasive means of treating uterine fibroids is available in South Africa. Fibroids are growths that develop on the wall of the uterus, which can cause heavy bleeding, intense period pain, and sometimes, infertility.
“Uterine fibroids affect many women’s lives, but few know about uterine fibroid embolisation, as it is a treatment option that is currently limited to just a few South African facilities,” says Dr Gary Sudwarts, an interventional radiologist who is based at UCT Private Academic Hospital. Uterine fibroid embolisation (UFE) has recently been made available in Cape Town by Dr Sudwarts at the hospital.
Dr Sudwarts says UFE is an alternative treatment for uterine fibroids and compares most favourably against other options such as an open myomectomy (a surgical procedure where the fibroids are completely excised) or hysterectomy. He explains that many women prefer not to undergo the radical surgical option of open myomectomy. Others, particularly younger women, do not wish to undergo a hysterectomy, which makes it impossible to bear children.
Dr Sudwarts says the great majority of women who have undergone UFE experience significant or total relief of heavy bleeding, pain and symptoms related to the enlarged uterus (bulk-type symptoms). Other problems it can help resolve include heaviness and discomfort; abdominal bloating, constipation, urinary frequency or incontinence, and leg or back pain. According to the American College of Obstetricians and Gynecologists, UFE, is “safe and effective”. It is a recommended treatment in many developed countries such as the United Kingdom where the National Health Service (NHS) offers the treatment in appropriate cases. In South Africa most major medical schemes fund UFE as they have come to understand both the importance and cost effectiveness of the procedure.
“Uterine fibroids are benign or non-cancerous overgrowths that develop in 20 to 40% of women over 35 years of age. As the most common reason for hysterectomy in pre-menopausal women, it is a major public health issue. Of the 600 000 hysterectomies performed annually in the United States, one-third are due to uterine fibroids,” says Dr Sudwarts.
In South Africa, UFE is usually performed by interventional radiologists – doctors specialising in minimally invasive, targeted treatments. This procedure is done with the aid of traditional imaging tools such as X-rays, ultrasound and magnetic resonance imaging (MRI) while the patient is conscious but sedated to eliminate pain. Microscopic particles are injected into the arteries supplying the fibroids, causing them to shrink. The patient usually stays in hospital overnight. According to Dr Sudwarts, the procedure has lower rate of complications, less pain and shorter recovery time compared with open surgery.
As with any medical procedure there are some related risks to UFE. For example, a small number of patients have experienced infection, but this can usually be readily controlled with antibiotics. Occasionally the fibroids recur requiring a repeat embolisation or open surgery.
Dr Sudwarts explains that UFE as a treatment option in South Africa is currently limited to the major centres as it is a highly specialised procedure requiring sophisticated equipment. In addition to UCT Private Academic Hospital, UFE is also offered at Netcare Sunninghill Hospital and Netcare Garden City hospitals in Johannesburg and at Netcare St Augustine’s Hospital in Durban.
UCT Private Academic Hospital general manager, Liselle Shield, says the facility continues to invest in cutting edge technology so that patient treatment and outcomes may be optimised. “It is a privilege to work with Dr Sudwarts in bringing this highly effective treatment to the women of Cape Town,” she concludes.
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