Interview with Dr Andrew Lawson on Uterine Fibroid Embolisation
Interventional Radiologist at Bokamoso Private Hospital, Dr Andrew Lawson can treat a variety of conditions including, uterine fibroids with a minimally invasive procedure known as Uterine Fibroid Embolisation. Sunhealth chats with him to give you the facts on the procedure that helps many women with uterine fibroids avoid hysterectomy surgery.
Can you provide a brief overview of your experience and expertise in interventional radiology, specifically in fibroid embolisation?
I am an interventional radiologist with a specific interest in UFE (uterine fibroid embolisation). I have been doing UFE for 10 years now and I have treated 2000 patients across the sub-continent with UFE.
What are fibroids and fibroid embolisation?
Fibroids are non-cancerous growth in the muscle of the womb. We are not sure what causes them, but they are very common and occur in 3 out of 5 women! Fibroid embolisation is the process we use to block the blood supply to the fibroids, which starves them of oxygen and food thereby causing them to die and shrink and make troublesome symptoms go away without the need for surgery.
Who is most at risk of developing fibroids?
Women between the ages of 25 – 55 years old, i.e. ladies before the menopause.
How are fibroids diagnosed?
Fibroids are diagnosed when a doctor does a sonar or ultrasound scan.
And what can happen if they go untreated?
Fibroids are non cancerous, so they won’t kill you, but the symptoms like heavy bleeding just get worse and worse
Can you walk us through the typical steps of a fibroid embolisation procedure?
The procedure is very quick, taking 15-20min to do. There is no pain in the procedure, so you are wide awake.It does require an overnight stay in hospital in order for us to control the after embolisation pain which we do by administering pain medication. By the following morning, you are ready to go home.
What imaging modalities do you use to guide the procedure, and why?
We use simple, low dose x-rays to guide us during the procedure
How do you assess the suitability of a patient for fibroid embolization?
All patients are seen by a gynaecologist prior to the process; we then repeat a sonar scan and match the patients clinical complaints to the imaging.
How does fibroid embolisation compare to surgical options like a hysterectomy or a myomectomy?
Well, UFE preserves the womb, so we cannot compare it to hysterectomy which means complete womb removal. UFE compared to myomectomy, removal of fibroids… Well one of the many big advantages of UFE is the low re-growth rate of fibroids…vs myomectomy where the fibroids are almost guaranteed to regrow
What are the potential risks or complications associated with fibroid embolisation?
Fortunately it’s a very low risk procedure with a low complication profile if performed by a skilled operator.
Are there any specific pre-procedural preparations or tests that patients need to undergo?
Only the sonar scan
How effective is fibroid embolisation?
It treats fibroid related symptoms with a 95% success rate.
Are there ways to prevent fibroids from developing in the future?
No
Can you discuss any innovative techniques or tools you’ve implemented to improve procedural outcomes or efficiency?
Yes, we are able to do the procedure very quickly, so it means you don’t need ANY anaesthesia, so you are awake immediately after the procedure, so there is less risk of complications. We have an excellent pain treatment algorithm keeping our patients comfortable during the first 16hrs of healing after UFE
What outcomes do you typically expect following fibroid embolisation, both in terms of symptom relief and imaging findings?
The fibroids shrink by about 60% over 6-8 months, some in fact vanish completely. Symptom resolution we see in 95% of patients.
How do you monitor patients post-embolisation, and what are the key follow-up milestones?
The monitoring is clinical: are the symptoms improving… the milestones are usually the 2nd and 3rd period after UFE where the marked reduction in menstrual flow will be noted.
Can you share any notable patient success stories or challenging cases you have encountered?
We have multiple such stories where ladies have been admitted to hospital prior to UFE due to torrential bleeding from the fibroids, after UFE they walk out of hospital and never need blood transfusions again. Women often deal with poor quality of life for years after finding out they have fibroids because they aren’t aware of all the options available for their symptom relief—including an option like UFE .
How do you, as a radiologist, go about raising awareness about this?
For starters, we offer the best professional advice and guidance for a lady with fibroids. We are honest and advise what might be best suited to HER needs.
Should she be a candidate for UFE, we do the procedure well and professionally ensuring she has the best chance of a successful outcome. We ensure that we work with out gynaecological colleagues and development a good working relationship. UFE is now a well established modality of treatment for fibroids. Both community members and medical professionals still need to be made aware of UFE but this takes time and patience.