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Few Women Hear about Uterine Fibroid Embolization (UFE) Treatment Option Directly from Gynecologists John C. Lipman, MD, FSIR Director, Interventional

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  • Few Women Hear about Uterine Fibroid Embolization (UFE) Treatment Option Directly from Gynecologists John C. Lipman, MD, FSIR Director, Interventional Radiology Emory-Adventist Hospital Atlanta, Georgia
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  • Fibroid Facts Most common tumor of female genital tract. 1 in 3 women >35yrs. of age. As high as 75% in reproductive age African- American women. Most common indication for (>600,000) hysterectomy in the U.S. (hysterectomy 2 nd most common surgical procedure in the US). Costs: $5 billion/year spent in U.S. for fibroids (primarily on the cost incurred from hysterectomy).
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  • Fibroid Symptoms Most frequent cause of abnormal uterine bleeding. Typically starts as a prolonged menses, which can lead to anemia (can be severe). Gushing, flooding, and soiling clothes in blood. Millions of silent sufferers in US. Women that dont want hysterectomy yet have been told by their gynecologist that there is no other option.
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  • Menorrhagia I have to wear a d**n diaper (Depends), a flat maxi pad heaviest flow, plus a thick pad, plus a super deluxe tampon. When I have a gush, it only stops the clots, not the gush. Im in trouble no matter how padded up I am. If Im not near a bathroom, I m a sunken ship. Today, I definitely was sunk because I was out without my Depends on ! I have to work. I just cant keep getting up and leaving whenever this happens. I bet Ive raised eyebrows and I cant afford to lose my job. Ive been there too. I was shaking my head reading your message. I shop at Costco and buy the hugest box of the biggest, heavy duty pads, along with the super tampons, and Depends. Sometimes, I will have all this gear on just to go to the grocery store or a quick errand. It is a pain. I can handle it in the winter, but its horrible in the summer. I was at my sons baseball game one night when a gusher hit. Lets just say it wasnt pretty. Hope the bleeding stops soon for you.
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  • Fibroid Symptoms cont Bulk symptoms are the other major symptoms from fibroids. -Pelvic pain/pressure. -Urinary pressure/frequency. Often wake up in the middle of the night. -If large can block kidneys, bowel (constipation). -Painful intercourse.
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  • Pelvic MRI
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  • Uterine Fibroid Embolization Technique Performed by Interventional Radiologists Minimally-invasive outpatient (or at most overnight stay) procedure, 4-5 days average recovery, average 1 week away from work. Arterial catheterization using imaging guidance into the uterine arteries, with occlusion of fibroid vessels by embolic materials (most common acrylic beads or particles made from contact lens material). The symptoms usually significantly improve or completely resolve within several weeks.
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  • Uterine Fibroid Embolization Technique
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  • Pre & 6 months Post UFE
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  • Community Awareness of UFE as a Treatment Option for Symptomatic Fibroids 105 consecutive patients suffering with fibroids seen in the office All 105 were given surgery as an option, but only 35 (33%) were given UFE as an option. Of these 35, 20 of these pts were from Kaiser Ob/Gyn which uniformly inform patients of all their options. Excluding these 20, only 15 of the remaining 85 (18%), were told about UFE as an option. 9 of 70 (13%) that werent told were looking for a new gynecologist; 0 of the 35 that were told expressed this. The majority of the 70 women that were not told about UFE, yet came for consultation for UFE, learned about it through the internet.
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  • Conclusions Scientific evidence of the safety and long-term efficacy of UFE is irrefutable. While the internet is a great tool, and I encourage patients to empower themselves with knowledge about their medical condition, they should not have to suggest their treatment to physicians. This is the our (physicians) responsibility. Gynecologists need to take the lead and incorporate UFE into the treatment algorithm for women suffering with symptomatic fibroids. I applaud Kaiser Permanentes gynecologists for taking the lead in the Atlanta area.

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