TOLEDO, Ohio (Special to the NNPA from the Toledo Journal) — Many may not realize it, but there is a safe and effective medical treatment that can help women suffering from fibroids avoid undergoing a hysterectomy.
Dr. Ravi Kodali, a Toledo interventional radiologist, said he has performed about 50 uterine fibroid embolizations (UFE) over the past 10 years.
“These women were all candidates for hysterectomy,” he said at St. Luke’s Hospital, one of four area hospitals where he and other interventional radiologists perform UFEs. Dr. Kodali said he doesn’t know how many women regionally have undergone hysterectomies over the past decade but is certain many of them could have avoided the surgery, which makes pregnancy impossible. Uterine fibroids most often develop in women ages 35 to 50 — and African Americans are especially susceptible — but they also can occur in women in their 20s.
Nationally, more than 600,000 women undergo hysterectomies each year and uterine fibroids are “the number one indication” for that surgery, Dr. Kodali said.
His 50 UFE procedures are “not a huge number” although a majority of his patients — all who have had successful outcomes — have been African Americans. So why aren’t more women taking advantage of the alternative treatment, especially since UFE has been used in the U.S. for about 15 years and has been documented by radiologist and gynecologist organizations as effective? Lack of education and outreach, Dr. Kodali said.
“I would say there are some [areas] of the country where there’s a lot more coordination with the gynecologists, where patients are being offered that opportunity,” he said. “Regionally it’s not being offered, probably because of lack of knowledge of availability of the procedure. I think that’s the main thing. The patients we are seeing are the ones seeking us out. That’s what gynecologists are comfortable doing,” he added, referring to hysterectomies. “It’s their patient. They’re seeing that as a definitive treatment.”
Between 30 and 40 percent of American women develop fibroids, although a smaller percentage experience pain and bleeding because of them.
The fibroids themselves are benign but they can cause pain and bleeding. During a UFE, a radiologist injects particles into blood vessels to block blood supply to the fibroids.
“Because they can’t get any blood or nutrients, they will shrink over time,” Dr. Kodali explains. “And the shrinking of the fibroids will treat the symptoms.”
What are the benefits of UFE? According to the Radiological Society of North America:
• Uterine fibroid embolization is much less invasive than open surgery done to remove uterine fibroids or the whole uterus (hysterectomy).
• No surgical incision is needed, only a small nick in the skin that does not have to be stitched closed.
• Patients ordinarily can resume their usual activities weeks earlier than if they had a hysterectomy.
• Blood loss during uterine fibroid embolization is minimal, the recovery time is much shorter than for hysterectomy, and general anesthesia is not required.
• Follow-up studies have shown that 90 to 95 percent of women who have their fibroids treated by uterine fibroid embolization experience either significant or complete resolution of their fibroid-related symptoms.
“It’s not a hundred percent, but it’s close,” Dr. Kodali said.
Most of his patients have stayed overnight at a hospital following the procedure but some have returned home the same day. They may experience discomfort, but for only three to seven days compared to two months for a hysterectomy.
“Typically a patient will show up in the morning, have the procedure done, and the biggest challenge we face, because these fibroids are effectively dying, is pain management,” Dr. Kodali said.
UFEs were first performed in France in 1991 and has been used in the U.S. for about 15 years, the radiologist said. Locally, he and three other interventional radiologists at the 20-member Consulting Radiologists Corp. on Laskey Road perform UFE at St. Vincent Mercy Medical Center, and at St. Charles, St. Anne’s and St. Luke’s hospitals.
In some areas of the country, UFE is “basically the procedure of choice for fibroids,” Dr. Kodali said.
“We’re not there yet. That’s our goal, ultimately.
“That’s the biggest challenge we face right now, is getting the public to be aware of the procedure,” he added. “Frankly, that’s our own fault for not getting that message out there. ... A lot of people don’t know what interventional radiologists do. That includes medical and non-medical personnel.”
Dr. Kodali, who has been practicing in Toledo for five years, received his medical degree at the University of Michigan and did his training at Henry Ford Hospital in Michigan. He decided to expand from diagnostic radiology into interventional radiology. “It’s a couple years of training on top of your basic radiology training,” he said.
Thanks to the Internet, more and more women seeking information on their fibroid symptoms are learning about UFE, Dr. Kodali. He hopes more will become aware of the procedure, especially those who want to have babies.
“Today what we have shown is that generally people who have wanted to have children have been able to,” he said. “Once you have a hysterectomy, obviously you can’t have children.”
This article was originally published in the July 20, 2009 print edition of The Louisiana Weekly newspaper |
