Dornetta Gray says she suffered with uterine fibroids for “probably 20 years.”

        She didn't want a hysterectomy. Her gynecologist had already suggested the surgery, “but I wasn't listening. It was just something that I really didn't want to do.”

        She learned she had another option one day at the medical billing service where she works: Uterine fibroid embolization, or UFE, a non-surgical alternative to hysterectomy chosen by more and more women plagued by fibroids.

        Dr. Joseph Bernstein, an interventional radiologist, has been performing the procedure at Jewish Hospital for three years. He was the first doctor in Cincinnati to offer the procedure. Most of his patients came in on their own as they learned it was available.

        “If you go back three years ago, the people who were calling for the procedure were surfing the Internet or had talked to their friends about it,” he says.

        Now many of his patients are referred by their gynecologists.

        Until the embolization procedure became available, women had three basic options for treating uterine fibroids: Drugs, including hormone therapy, to shrink the fibroids; myomectomy, or surgical removal of the fibroids, which are non-cancerous tumor-like growths in the muscular wall of the uterus; or hysterectomy, the surgical removal of the entire uterus.

        Fibroids can cause abnormally heavy bleeding during and between menstrual periods, cramps, pressure on the bladder and bowel, and pain in the vaginal area, back and abdomen. Some fibroids can grow to the size of cantaloupes and resemble a five-month pregnancy. Fibroids are the cause for about a third of the 600,000 hysterectomies performed annually in the United States.

        Mrs. Gray underwent the procedure in January. There was “a little pain” afterwards, she says, “but it was nothing compared to the pain I suffered every month.” She's had no problems since the procedure, she says.

        Medications don't always work to shrink fibroids, and hormone therapy can produce the same symptoms as menopause. Myomectomy can cause scarring in the uterus and may affect a woman's ability to become pregnant. And many women are reluctant to undergo hysterectomy, both for emotional reasons and because they don't want major surgery.

        In UFE, an inert plastic or gelatin is inserted into the blood vessels that feed the fibroid by a catheter. The plastic substance blocks the blood vessels, and the fibroid shrinks. Some women may be able to leave the hospital the same day; most stay overnight, then go home for a few days before returning to work. For a hysterectomy, women may spend three to five days in the hospital, and recovery can take four to six weeks, says Dr. Darren Hurst, an interventional radiologist with Radiology Associates of Northern Kentucky.

        At this point, UFE is only recommended for women who don't want children, Dr. Hurst says. The rate of ovarian failure after the procedure is only about 5 percent, but the procedure is still new enough that doctors don't have a great deal of data. For women who know they want children, doctors usually recommend myomectomy or medication.

        UFE isn't for everyone with uterine fibroids, says Dr. Bernstein. Women who have bleeding between periods or who have had abnormal Pap smears or biopsies aren't candidates for UFEs.

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