Keep Your Uterus – Former U.S. Secretary of State Condoleezza Rice Chooses Interventional Approach to Treat Uterine Fibroids
On November 19, 2004, major media outlets around the world published reports that Condoleezza Rice, who had just been nominated to become the next Secretary of State, had undergone an interventional procedure for uterine fibroids (fibroid embolization), causing a strong reaction among fibroid patients.
The procedure was performed by interventional radiologist Dr. James Spies. The entire procedure took an hour and a half and ended at 10:15 a.m. that day, with Rice returning to her room. At the doctor’s request, Rice spent one night in the hospital before returning home on the 20th and to work on the 22nd.
Why did Rice undergo the procedure with an interventional radiologist instead of an OB/GYN? Why was she only in the hospital for one night?
Uterine fibroids are common benign tumors of the reproductive system in women of childbearing age, with an incidence of 20% to 25%. Patients may have different degrees of pelvic pain, uterine bleeding, abdominal distension, bladder rectum and other pressure symptoms.
The traditional treatment methods are mainly as follows
① Drug treatment. It is mainly hormone therapy, which is effective in shrinking fibroids and reducing symptoms, but the course of treatment is long and slow, and the long-term application of toxic side effects is great.
② Surgical treatment. Myoma removal has a high recurrence rate of 25%-30%; total hysterectomy is very traumatic and painful, and it also has an impact on endocrine, especially for young patients who wish to keep their uterus, which is difficult to accept.
The uterine fibroid embolization procedure that Rice underwent was different from the traditional surgical method, and was a minimally invasive interventional procedure that required no incision. A small 2 mm incision is made in the femoral artery of the patient’s thigh, and a very thin catheter is passed along the vessel into the uterine artery, which is then superselected to the fibroid supply artery, where an embolic agent is injected. In this way, the blood and nutrient supply to the fibroids is blocked and the fibroids are gradually reduced or eliminated for the purpose of treatment. This treatment is less invasive, leaves no scars after surgery, has fewer complications, quick recovery, and is easily accepted by patients, who can get out of bed the day after surgery. It has become the first choice for patients with uterine fibroids in many countries.
As early as in the 1990s, hospitals in China carried out arterial embolization interventions for uterine fibroids and achieved remarkable results. However, because the word “intervention” is a foreign word, many patients know little about “interventional” therapy, and those who could have received minimally invasive surgery have been subjected to “major surgery” due to lack of medical knowledge. In contrast to hysterectomy, embolization of benign fibroids is minimally invasive, results in rapid recovery, and is more easily controlled.
What types of fibroids are suitable for uterine artery embolization?
(1) Bleeding due to fibroids (heavy menstrual flow, prolonged menstruation)
②Lower back and abdominal pain caused by fibroids
③Pelvic distension and rectal pressure caused by fibroids
④Symptoms of recurrence of fibroids after myomectomy, except for those with malignant changes.
Which patients with fibroids are not suitable for uterine artery embolization?
①Contraindications for angiography, including dysfunction of heart, liver, kidney and other important organs, abnormal coagulation mechanism
(ii) Acute and chronic gynecological inflammation that cannot be effectively controlled
③ Other relative contraindications include postmenopause, severe atherosclerosis and advanced age
④Uterine arteriovenous fistula.