Women with problematic fibroids now have a medical solution closer home in the form of a non-surgical alternative. Known as Uterine Fibroid Embolisation, the procedure involves a neat tuck where a catheter is inserted to introduce particles of gel or plastic that block the arteries that ‘feed’ the fibroids.
Florence Smythe, 43, is one of the first patients to undergo the new fibroid treatment in the continent and country.
Florence had lived with fibroids for five years before heavy bleeding and a bloated stomach sent her knocking on the gynecologists’ door who advised her to have a hysterectomy.
“Though I was done with having children, the thought of losing my uterus was not an option so I opted to seek further medical advice since fibroids are not life threatening.”
According to Dr Nigel Hacking, an interventional radiologist who performed the procedure last year, an x-ray camera guides the delivery of small particles to the uterus and fibroids.
“The small particles are injected through a thin, flexible tube called a catheter,” Dr Hacking told Saturday Magazine in an interview to mark one year since the procedure pioneered at Aga Khan Hospital.
The procedure involves inserting a catheter through the groin, maneuvering it through the uterine artery, and injecting the embolic agent into the arteries that supply blood to the uterus and fibroids. These block the arteries that provide blood flow, causing the fibroids to shrink, Dr Hacking added.
As the fibroids begin to shrink, the uterus fully recovers.
Fibroids are non-cancerous growths of the muscle of the uterus which occurs in women during their reproductive years. Also known as myomas, they are non-cancerous tumors that arise from the muscular wall of the uterus.
They are known to cause heavy menstrual bleeding, pain in the pelvic region, and pressure on the bladder or bowel.
Black women
Medical research indicates that one in five women has fibroids and black women are two to three times more likely to have them compared to their white counterparts. The growths do not cause any symptoms and can be left alone without treatment.
When she was diagnosed with fibroids in 2005, it took Florence three years and several doctors later before the new treatment procedure, was introduced in the country last year came to her rescue.
One of the advantages, Dr Hacking notes is that the procedure is minimally invasive thus a good option for women particular on aesthetics. Nearly 90 per cent of women with fibroids experience relief of their symptoms.
However, Dr Hacking clarifies that the procedure is typically offered to women who no longer wish to become pregnant or who want or need to avoid having their uterus removed.
Another advantage is that blood loss during the procedure is minimal, recovery time is much shorter than for hysterectomy, and general anesthesia is not required.
However, the cost could be prohibitive for the average Kenyan woman at Sh300,000.
Another setback is that just like any other operation, damage to the blood vessel could occur, and there could be bruising or bleeding at the puncture site, and infection.
The procedure lasts 15 to 45 minutes and the patient is hospitalised for a day for observation and can resume work in a fortnight.
Patients with high blood pressure and blood clots do not qualify for the procedure.
Aga Khan University Hospital Department of Obstetrics and Gynaecology Chairman, Prof. William Stones says the treatment is best suited for patients who want to avoid open surgery or have complications resulting from a surgical operation.
“UFE is recommended as a non-surgical alternative for patients who do not want open surgery or have risks resulting from surgical complications, a history of keloid scars, blood clots or medical conditions that may complicate anaesthesia,” said Prof Stones.
“I can now perform normal house duties and my periods are no longer heavy,” Florence says of her life, a year after the procedure. I am grateful I no longer experience the bloated-stomach feeling,” she adds.
The procedure is also an option for patients who may wish to conceive in the future and is an effective method of reducing menstrual blood loss for those patients with anaemia. It is also painless operation and thus does not need a full anaesthesia.
“A patient is provided with painkillers during the night at the hospital, followed by tablets for two to seven days after being discharged,” he said.
It is thus possible to resume normal daily activity and a return to duty, for working women, within the first two weeks.
UFE is a well-established procedure internationally particularly in the United Kingdom where national guidelines recommend that the procedure should be offered to women with symptomatic uterine fibroids.
Amongst other precautions is that Uterine fibroid Embolisation should not be performed on women who have no symptoms from their fibroid tumors, when cancer is a possibility, or when there is inflammation or infection in the pelvis.
It should also be avoided in women who are pregnant or in women whose kidneys are not working properly.
Florence says the procedure has not only given her a new lease on life but has also encouraged her to create awareness among her peers.
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