Linda Johnson, a 37-year-old hospital administrator, thought signs of impending middle age had arrived early in her life. Her abdomen had become bulky; menstrual bleeding was heavy; she was incontinent and had recurring pelvic pain. Johnson’s gynecologist found instead that she had a fibroid the size of an orange in her uterus.
Fibroids are benign tumors that affect 40 percent of all women over 40. As in Johnson’s case they can become troublesome as they continue to grow and even prevent pregnancy. Traditional treatment usually involves surgical removal of only the fibroids (myomectomy) or complete hysterectomy. For Johnson, a myomectomy would have left her with the chance the fibroids would return; a hysterectomy would dash her hopes of becoming pregnant. Eventually Johnson ended up at Hopkins where she was offered a new therapy called uterine fibroid embolization, which can eliminate fibroids without destroying the uterus. The surgeon makes a quarter-inch incision into the groin. A catheter is then threaded into the uterine artery that supplies blood to the fibroids, and small beads composed of polyvinyl alcohol, or PVA, are injected into the artery, plugging the vessels that feed the fibroids. Deprived of blood and needed oxygen, the growths die and shrink. The uterus lives on. “Although you’re temporarily decreasing oxygen to the uterus, it doesn’t infarct or die because it is very vascular and will rely on blood supply from other parts of the pelvic circulation system, like the ovarian arteries,” explains interventional radiologist Adam Winick, M.D. “Fibroids, which also live off oxygen, don’t have this ability and the tissue will die.” After a one-night stay in the hospital, the patient recovers at home over five to seven days. “It’s wonderful,” Johnson says. “The tumors have shrunk to grape size, and the symptoms are gone.” Hopkins Medical News
Spring 2000 | 
