Fibroid treatment in Houston & Dallas without surgery

Uterine fibroids are benign (non-cancerous) tumors that grow from the smooth muscle cells of the uterus. While their exact cause is unknown, hormones are known to promote their development. Some women have no symptoms, but many experience symptoms that significantly affect their quality of life, including heavy menstrual bleeding, pelvic pain or pressure, and bulk-related symptoms such as urinary frequency.

Fibroids are extremely common — in fact, they are the most common pelvic tumor in women, and they are more common in African-American women. By age 35, 40% of Caucasian women and 60% of African-American women will have fibroids. By age 50, that rises to 70% of Caucasian women and more than 80% of African-American women, who are also more likely to experience symptoms.

The symptoms of uterine fibroids fall into three main groups: heavy menstrual bleeding, pelvic pain, and bulk symptoms related to the size or position of the fibroids.
Heavy menstrual bleeding is the most common symptom and can lead to anemia and severe fatigue. For some women, bleeding is heavy enough to cause them to miss work or avoid normal activities, and in severe cases it can require blood transfusions.

Pelvic pain affects nearly two-thirds of women with symptomatic fibroids, and it is the dominant symptom in more than 10% of patients.

Bulk symptoms are caused by the size and location of the fibroids. Large fibroids can cause bloating, pressure, or heaviness, as well as painful intercourse. Pressure on the bladder can cause urinary frequency, and large fibroids may also lead to low back pain, constipation, and leg pain, swelling, or heaviness.

Symptomatic fibroids are usually diagnosed from your clinical history and confirmed with a pelvic ultrasound. Because fibroids can also be asymptomatic, they are sometimes discovered incidentally during a routine pelvic exam.

When symptoms are present — such as heavy menstrual bleeding, pelvic pain or pressure, or urinary frequency — an ultrasound is typically the first step. If the ultrasound confirms fibroids, the next step is to discuss treatment options. For women considering uterine fibroid embolization (UFE), a pelvic MRI is performed to accurately visualize the fibroids, uterus, and surrounding structures.

No, it is not necessary to treat all uterine fibroids. Many women with fibroids are completely asymptomatic and don't need treatment. Care is usually reserved for women experiencing symptoms such as heavy bleeding, pelvic pain, or bulk symptoms like urinary frequency.

Because fibroids are benign (not cancer), asymptomatic fibroids can often simply be monitored. Newly discovered fibroids should be followed for a period of time to check for rapid growth, which could indicate something other than a benign fibroid.

Treatment for uterine fibroids ranges from monitoring to medication to procedures, and the right choice depends on your symptoms, your goals, and whether you wish to preserve your uterus. Not every fibroid needs treatment — asymptomatic fibroids are often simply monitored. For women who do need treatment, the main options are:

• Watchful waiting — monitoring fibroids that aren't causing symptoms.
• Medication or hormonal therapy — to help manage symptoms such as heavy bleeding.
• Myomectomy — a surgical procedure that removes individual fibroids while preserving the uterus.
• Hysterectomy — the surgical removal of the uterus.
• Uterine fibroid embolization (UFE) — a minimally invasive, non-surgical, outpatient procedure that shrinks fibroids by cutting off their blood supply.

UFE has become a leading choice for women who want lasting symptom relief without surgery and without losing the uterus.

No, a hysterectomy is not the only option. Although roughly 700,000 hysterectomies are performed each year in the United States — most of them due to fibroids — many women are unaware that less invasive alternatives exist. A hysterectomy is major surgery that requires a 4–6 week recovery and leaves a large permanent abdominal scar.

Uterine fibroid embolization (UFE) is a non-surgical alternative for women with symptomatic fibroids who want to avoid major surgery. It is an outpatient procedure with far less downtime than a hysterectomy and leaves no significant visible scar. A 2008 practice bulletin from the American College of Obstetricians and Gynecologists (ACOG) states that uterine artery embolization is a safe and effective treatment option for women with fibroids who wish to retain their uterus

Uterine fibroid embolization (UFE) is a minimally invasive, non-surgical, outpatient procedure that treats fibroids by cutting off their blood supply. During the procedure, a small catheter — a flexible tube less than 2 mm in diameter — is inserted into an artery in the wrist or groin and guided into the pelvic arteries using X-ray imaging. Angiograms map the blood vessels supplying the uterus, and tiny particles are then injected into the uterine arteries. These particles travel downstream and block the blood supply to the fibroids, causing them to shrink and the symptoms to resolve.

Because UFE is an outpatient procedure, there is no hospital stay. Most women go home within a few hours and recover at home. Unlike a hysterectomy, UFE leaves no significant visible scar and requires no lengthy recovery — most women return to work and normal activities within one week, with very high patient satisfaction.

After UFE, fibroids lose their blood supply, shrink, and stop causing symptoms. The small particles injected into the uterine arteries block blood flow to the fibroids, so the heavy bleeding and pain they cause resolve quickly.

Over time, the fibroids shrink to about one-third of their original size. As they shrink, they stop pressing on nearby structures such as the bladder. The particles used in UFE are completely inert — they will not cause adverse reactions or migrate elsewhere in the body. For women with fibroids, UFE is a very safe option with excellent long-term results and high patient satisfaction.

The main difference is that UFE preserves the uterus while a hysterectomy removes it. Both treat fibroids effectively, but they differ significantly in invasiveness, recovery, and scarring.

A hysterectomy is major surgery. It typically requires a 4–6 week recovery, significant time off work, and leaves a surgical scar — a horizontal scar that can be hidden by a swimsuit if the uterus is small enough, or a more noticeable vertical midline scar if the uterus is moderately sized or larger. Women who form keloids may develop larger, more visible, and sometimes painful scars.

UFE is an outpatient, non-surgical procedure with minimal downtime. Most women resume normal activity and return to work after about one week. We perform UFE through an artery in the wrist, which allows faster recovery and leaves no noticeable scar. A 2008 ACOG practice bulletin confirms uterine artery embolization as a safe and effective option for women who wish to retain their uterus.

Yes, women with multiple fibroids are usually excellent candidates for UFE, because the procedure treats all fibroids at once. During UFE, tiny particles are injected into the uterine arteries and flow downstream to shut off the blood supply to every fibroid simultaneously.

Once their blood supply is cut off, the fibroids shrink and symptoms resolve — all treated equally during a single outpatient, non-surgical procedure.

Yes, UFE can treat a very large uterus with multiple fibroids. During the procedure, tiny particles are injected into the uterine arteries and flow downstream to cut off the blood supply to the fibroids, which then shrink to about one-third of their original size. For a large uterus, this reduction usually takes about 3 months, and sometimes up to 6 months depending on the original size.

If a patient's primary goal is to quickly regain a flat abdomen, a hysterectomy is a more direct route — though for a large uterus that typically requires a vertical midline incision. Most patients say a flat belly is not their main concern, and nearly all are happy with the reduction in bulk after UFE, though it does take time.

Adenomyosis is a condition in which the endometrium — the inner lining of the uterus — grows into the muscular wall of the uterus. These implants can cause painful menstrual cramps, heavy bleeding, bloating, and pelvic pain or pressure. Adenomyosis is difficult to detect on ultrasound but can be diagnosed with MRI, which is one reason we recommend a pelvic MRI before treatment.

Yes, UFE can treat adenomyosis. An intrauterine device (IUD) is an effective option for many patients, and those who don't respond to medical management have traditionally been treated with a hysterectomy. For women who wish to avoid major surgery, uterine artery embolization treats adenomyosis with excellent results: recent studies show short-term symptom improvement in more than 90% of patients, and one long-term study found that 82% of patients treated with embolization avoided a hysterectomy over more than 7 years of follow-up.

UFE is an extremely safe, non-surgical, outpatient procedure, and complications are uncommon. When they do occur, the most common are loss of the menstrual cycle and prolonged vaginal discharge.

During UFE, some of the injected particles can affect the ovaries, which may lead to early menopause. This is usually seen in women over age 45 and occurs in up to 15% of patients in that age group. Rarer complications include:

• Infection — a risk with most medical procedures; with UFE the chance is less than 1%.
• Fibroid expulsion — occurs in about 2% of patients, and the risk is higher for fibroids located within the uterine cavity. A pelvic MRI before your procedure helps us identify this risk and plan accordingly.
• Non-target embolization — when particles reach an unintended area; exceedingly rare, occurring in fewer than 1 in 1,000 patients.

UFE is highly successful at relieving fibroid symptoms. For women with heavy menstrual bleeding, the long-term success rate is around 95%. For bulk symptoms — urinary frequency, pelvic pain or pressure, constipation, and leg heaviness or swelling caused by the size of the fibroids — more than 90% of patients experience relief after UFE. Patient satisfaction following the procedure is also very high.

Fibroids that are fully treated during UFE usually do not come back. UFE works by injecting tiny particles that cut off the fibroids' blood supply, causing them to shrink and symptoms to resolve.

In rare cases, embolization can be incomplete and some fibroid tissue may remain. Because hormones produced by your body can cause residual fibroids to grow, that tissue could enlarge over time and bring symptoms back, occasionally requiring additional treatment. Even after all fibroids are fully treated, there is some chance of developing new fibroids as long as your body continues to produce hormones. After menopause, hormone levels drop significantly, which greatly reduces the likelihood of further fibroid growth.

Radial artery access means performing UFE through an artery in the wrist instead of the femoral artery in the groin. Historically, most angiogram-type procedures used the femoral artery, which requires the patient to lie flat for 4–6 hours afterward — unable to move or bend their legs, which most find very uncomfortable.

Wrist access is a newer, advanced technique that is safer and leads to faster recovery and higher satisfaction. With radial access, there is less pain during and after the procedure and fewer complications than with groin access. Patients can sit up, sit in a chair, and even walk almost immediately, and most go home within 1–2 hours. We are the first and only practice in the Houston area to perform UFE using the radial artery in the wrist.

Most women return to work and normal activities about one week after UFE. Because it is an outpatient procedure, there is no hospital stay — you go home the same day and recover at home.

You'll be with us for about 6 hours on your procedure day, and we send you home with medication to manage any discomfort afterward. Our team follows up frequently to ensure a smooth recovery.

Yes, many women have had successful pregnancies after UFE. Studies show that fertility and miscarriage rates in UFE patients are no different from those of women of the same age who have fibroids and have had no treatment.

That said, women who wish to preserve fertility may also consider a myomectomy — a surgical procedure that removes one or two fibroids and has been shown to improve fertility. A few studies suggest that pregnancy complications such as pre-term labor and pregnancy-induced hypertension (pre-eclampsia) may be slightly more common after UFE than after myomectomy. For women who are good candidates and willing to have surgery, a myomectomy may be preferable, but UFE remains an option for those who are not good surgical candidates or who prefer to avoid surgery.

Yes, all major insurance carriers cover uterine fibroid embolization, which is a well-established, widely accepted treatment for uterine fibroids. Because we perform every UFE procedure in our office on an outpatient basis, many patients are treated at a much lower out-of-pocket cost — for some, as little as an office-visit co-pay.

Our team is highly experienced with the insurance issues that can arise during fibroid evaluation and treatment, and we contact your insurance company directly to resolve any coverage questions before treatment.