Dr. Mike Rosen Explains Condoleeza Rice's Uterine Fibroids

National Security Adviser Condoleezza Rice, who was nominated by President George W. Bush Tuesday to be the next Secretary of State, underwent a minor surgical procedure Friday for a problem called uterine fibroids.

She is expected to go home Saturday and return to work on Monday. She had uterine fibroid embolization, a non-surgical procedure that has made the course following treatment much easier.

Uterine fibroids are benign tumors that can cause tremendous pain and bleeding and they can also interfere with becoming pregnant. They’re very common, typically seen in women once they hit their late thirties and forties.

Thursday, Rice got a procedure called uterine fibroid embolization. It is a non-surgical way to destroy the fibroids.

Because this isn't surgery, doctors have to gain access without cutting the patient open. They do this by placing a small catheter through a puncture hole in the skin into an artery in the groin.

Interventional radiologists, not surgeons, are the ones who perform the procedure which involves inserting a tube, or catheter into the arteries feeding the uterus.

”It’s passed in the arteries utilizing periodic special x-ray guidance into the artery first in the left side of the uterus,” says Dr. Khilnani of Cornell Vascular.

Before the embolization is started, an x-ray is performed to provide a road map of the blood supply to the uterus and fibroids. Then tiny coated gelatin balls the size of grains of sand are injected into the artery. They lodge into the blood vessels feeding the fibroids, which results in the blockage of blood flow.

Over several minutes the arteries are slowly blocked. The embolization is continued until there is nearly complete blockage of flow in the vessel. Once one side is completed, the other side is embolized. The procedure takes approximately 1 to 1 1/2 hours.

Patients are given a sedative and a local anesthetic during treatment and pain medication after the procedure. It's usually one overnight hospital stay and the pain subsides by the next morning. For the most part the procedure is actually painless; it's an hour after the procedure that the woman starts to develop menstrual like cramps. That's because the arteries feeding the fibroid are now blocked off, and that means there's no oxygen going to the muscle of the fibroid, and that's what causes the pain.

Complications are anticipated in less than 3 percent of patients. Serious possible complications include injury to the uterus from decreased blood supply or infection. Fortunately, this is quite rare and hysterectomy to treat either of these complications occurs in less than 1 percent of patients.

“We usually kill the fibroids in about 90 to 95 percent of the patients. And more importantly this works in eliminating the symptoms associated with fibroids,” states Dr. Khilnani.

After an initial period of bed rest for six to eight hours, those patients with mild to moderate symptoms of pain and nausea may be discharged.

Most patients are hospitalized overnight. Most symptoms are substantially improved by the next morning allowing discharge from the hospital, and most return to work 7 to 14 days after the procedure.

For more information on uterine fibroid embolization, click here.