The Role of Interventional Radiology in Minimally Invasive Women’s Healthcare  - Ellen Dolgen

The Role of Interventional Radiology in Minimally Invasive Women’s Healthcare 

In the past, traditional surgery was sometimes the only treatment available to alleviate many life-altering symptoms, such as uterine fibroids, infertility, chronic pelvic pain, and varicose veins, to name a few.  Now, Interventional Radiology plays a significant role in women’s healthcare.

I recently had the opportunity to chat with Dr. Rupal Parikh, an Interventional Radiologist (IR) and Professor of Radiology at UC San Diego Health.  I asked Dr. Parikh to help educate us on how her specialty interfaces with women’s healthcare.

What is Interventional Radiology or IR?

Interventional Radiology, also known as IR, is a specialty in the field of medicine that uses a minimally invasive approach to perform image-guided procedures using ultrasound, x-rays, CT scans, and/or MRI. Examples of procedures done by IR physicians include treating fibroids, adenomyosis, pelvic congestion, blood clots and other vascular diseases, infertility, cancer in different organs including the liver, kidneys, and lungs, bleeding related to trauma or the gastrointestinal tract, and abscesses, just to name of few.

What does an IR doctor specializing in Women’s Health treat?

An IR doctor specializing in Women’s Health manages and treats women with uterine fibroids, uterine adenomyosis, placental implantation abnormalities during pregnancy, pelvic venous disorders including pelvic congestion, infertility related to fallopian tube obstruction, and breast tumors in addition to treating more general conditions that all IR doctors offer.

What is ‘Uterine Artery Embolization’ or UAE procedure?

A uterine artery embolization procedure, also known as a UAE, is a minimally-invasive approach to treat symptomatic uterine fibroids, symptomatic uterine adenomyosis, placental implantation abnormalities during pregnancy, as well as bleeding from the uterus in the post-surgical or post-partum setting. Symptoms from uterine fibroids or adenomyosis can include heavy and/or irregular bleeding, pelvic pain, urinary urgency, constipation, and infertility. In treating symptomatic uterine fibroids or adenomyosis, a small straw-like catheter is placed in a blood vessel at the top of the leg or sometimes in the wrist. Through this access, a smaller catheter is navigated to the blood vessel that supplies the uterus, called the uterine artery. Most women have one left and one right uterine artery. Pictures of the arterial anatomy of the uterus are taken with contrast and X-ray imaging. Based on these pictures, an embolization procedure is performed using small particles or spheres to plug up the uterine arteries and remove the blood supply from the uterine fibroids and/or adenomyosis. Without this blood supply, the fibroids/adenomyosis can no longer flourish. Over time the fibroids/adenomyosis decrease in size and symptoms improve. Thus, uterine artery embolization is a minimally-invasive alternative to surgical options such as myomectomy or hysterectomy. It is associated with a shorter hospital stay and a faster recovery time compared to surgical alternatives, and one embolization procedure typically treats all fibroids/adenomyosis.

Can UAE lead to menopause?

Because the arteries supplying the uterus can have small connections to the ovarian arteries, the particles used for embolizing the uterine arteries can hypothetically travel through these small connections into the ovarian arteries and cause pre-mature menopause or cessation of menstruation. The chance of this is between 3-7%, with women over 45 years representing the majority of those who may develop premature menopause. The chance of premature menopause is similar between a UAE procedure and a hysterectomy. That being said, pregnancy after a UAE is certainly possible and not uncommon in those women desiring fertility though those who have not completed childbearing should also be evaluated for candidacy for a myomectomy.

Can UAE help in menopause?

UAE certainly can help menopausal/peri-menopausal women with a history of symptomatic uterine fibroids/adenomyosis who are started on hormone replacement therapy (HRT) to relieve menopausal symptoms such as hot flashes and vaginal discomfort. As fibroids and adenomyosis are hormone-sensitive, HRT can increase the symptoms from and size of existing fibroids/adenomyosis. One treatment option for women with recurrence of symptomatic uterine fibroids/adenomyosis after starting HRT is uterine artery embolization!

You usually need a referral from your primary care physician, gynecologist, or another healthcare provider to get a consultation with an IR.

Thank you, Dr. Rupal, for enlightening us on how an Interventional Radiologist can provide minimally invasive options that can improve outcomes, minimize risks, and enhance women’s overall well-being.

My Motto:  Suffering in silence is OUT! Reaching out is IN! 

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* does not recommend, endorse, or make any representation about any tests, studies, practices, procedures, treatments, services, opinions, healthcare providers, physicians, or medical institutions that may be mentioned or referenced.






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