Gynecological Myths in Fibroids and UFE

Written by
Michael Cumming, MD, MBA

Uterine fibroid embolization (UFE) competes with myomectomy and hysterectomy for the treatment of uterine fibroids.  All patients should be given factual information so that they can make the best treatment decision for themselves.  Too often the gynecological community gives misleading information so that they do not lose patients (and income) to interventional radiologists who perform uterine fibroid embolization.

Some of these myths include:

You may have a cancer so you need the fibroid removed

  • Less than 1% of fibroids are malignant.
  • MRI can identify over 99% of malignant fibroids.
  • Subjecting every patient to a hysterectomy because of this very small risk in not reasonable.

Sexual function get worse

  • The most recent publication on sexual function and UFE shows excellent outcomes with enhancement and improvement in women's sex lives.

You have the wrong kind of fibroids

  • The vast majority of fibroids can be treated with UFE.

Your fibroids are too large.

  • Size can impact the improvement in bulk symptoms as extremely large (>10 centimeter) fibroids may not shrink enough.

You can't get pregnant after UFE

  • Pregnancy is achievable after UFE with recent data showing it be equivalent to myomectomy.

You will end up in menopause after UFE

  • Only a very small percentage of patients, typically those that are perimenopausal, will end up in menopause after UFE.

UFE Pain is unbearable

  • Post embolization pain can be easily managed after embolization.  The vast majority of patients can be treated on an outpatient basis
  • Routine use of post embolization intra-arterial lidocaine and superior hypogastric nerve blocks significantly decreases pain.
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