As mothers, we sometimes put ourselves last when it comes to our health. But if you are experiencing abdominal or pelvic pain, why should you continue to suffer? You might have uterine fibroids. If you have questions or concerns about possible uterine fibroids, look no further! We recently sat down with Dr. Josh Dowell, a board certified interventional radiologist with Vascular & Interventional Physicians (VIP), a division of Northwest Radiology. He answered all of our questions about uterine fibroids and the minimally invasive procedure – uterine fibroid embolization – that could help reduce your pain.
Let’s start with the basics – what are uterine fibroids? What are the symptoms of uterine fibroids?
“Uterine fibroids are benign masses of the uterus,” says Dr. Dowell. “Many women have them – many times they don’t cause any problem – but for women that it does cause problems, it can cause significant problems for them. Half the patients that have fibroids will have significant symptoms.” Dr. Dowell continues by saying it depends on how large the fibroids are and if they are pushing against other organs. The symptoms of having uterine fibroids can include:
- Heavy bleeding during and/or between periods
- Frequent or urgent urination
- Constipation
- Abdominal and/or pelvic pain
- Pain down the leg (sciatica)
- Infertility
What are some other signs that women should pay attention to if they believe they may have uterine fibroids?
Dr. Dowell says one major sign of having uterine fibroids is if a woman has increased periods and if they are going through a lot of menstrual products, like pads or tampons, during their period throughout the day. He also said many of their patients that bleed heavily during their period or between periods may require iron supplements for anemia, or even blood transfusions due to low blood levels. In the past, the usual treatment for this was a hysterectomy, but in the past 20-30 years, uterine fibroid embolization has become more common. This is a minimally invasive, outpatient procedure, so there are other options beyond removing the uterus for patients that have fibroids.
If someone is diagnosed with uterine fibroids, explain the process of uterine fibroid embolization. Typically, how long is the procedure?
Most of the patients that come through the doors of VIP have a history of fibroids, are having difficulty conceiving, or have just had an ultrasound and diagnosis of uterine fibroids. An MRI is ordered, and the initial clinic visit gives the physician an opportunity to go over the imaging findings with the patient. There is always an MRI done to confirm fibroids and to see if the patient will respond well to an embolization.
The embolization procedure itself takes about an hour, and it is done through a very small catheter needle, about the size of angel hair pasta. The physician feeds the catheter through an artery and, under X-ray guidance, slides it down the uterine arteries which are the blood vessels that supply the uterine fibroids.
“The idea behind this treatment is we want to try to get rid of the blood supply to the fibroid to make the fibroid smaller,” says Dr. Dowell. He continues by saying that this procedure can shrink a fibroid by 40-50% in volume. They do this by injecting small beads into the fibroid to lower the blood supply. After this hour-long procedure, the patient is monitored for a few hours before released to go home and rest and recover.
What about post-op? How long does recovery take and what are the follow up procedures?
Dr. Dowell says to expect to take a week off to recover from the embolization. You may be a little tired, and the first night at home, you may expect some cramping. Medication(s) will be prescribed to help with the pain. This recovery is significantly less than when having a hysterectomy, which requires around six weeks to recover properly.
Other than expecting a week to recover, there are no restrictions afterwards. There will be one-month and three-month follow up appointments, and during the three-month appointment, another MRI will be done to see how much the fibroids have shrunk. By the three month mark, your symptoms should significantly improve. “Over 90% of women are going to get symptom relief from this treatment alone for their fibroids.” says Dr. Dowell. “They’re not going to have to go through a hysterectomy or any other procedure for it. The nice benefit we have from this procedure is not only just taking care of the one largest fibroid, we’re taking care of all the fibroids a patient has, and many patients have more than one fibroid.”
For more information, to schedule a consultation, and connect with Northwest Radiology, where can patients be directed?
If you have any questions or concerns, or if you think you have uterine fibroids, you can go through a referral from your doctor or contact VIP directly online. Head to the VIP Uterine Fibroid Embolization page to learn more about uterine fibroids, the embolization procedure, or to schedule a consultation. To book an appointment with the VIP location, call 317.328.7255 or click here.
Watch the full interview here:
About Joshua D. Dowell, MD, PhD, FSIR
Dr. Josh Dowell specializes in interventional radiology with Vascular & Interventional Physicians (VIP), a division of Northwest Radiology. He received his bachelor’s degree from Indiana University in Bloomington, completed the M.D., Ph.D. program at Indiana University School of Medicine, and also received a graduate certificate from the School of Public Health Sciences at the University of Virginia. He joined the Northwest Radiology team in 2016 and opened VIP in 2022.
Vascular & Interventional Physicians is a division of Northwest Radiology, located at 10603 North Meridian Street in Indianapolis. At Northwest Radiology, we are committed to making sure our patients feel heard and cared for. Our board-certified, sub-specialized radiologists are trusted by physicians throughout Indiana, and our technologists are experienced professionals who take you through every step of your procedure. You matter to us. And we want your experience with Northwest Radiology to be the best it can be.
