Relief From An Uncomfortable Life

Novel endoscopic procedure starves, shrinks uterine fibroids.

Rotonya Browder

For the past two years, Rotonya Browder has worked as a surgical technologist in a busy operating room. Her duties include prepping patients for surgery and assisting surgeons during procedures. While Rotonya enjoys her role in the OR, this wasn’t how she began her health care career or how she intends to finish it.

“Before I was a surgical tech, I was a laboratory technician for 17 years,” relates Rotonya. “Then I decided to switch areas. My specialties as a surgical tech are orthopedics, and labor and delivery, which I really like because I see lives come into the world. My ultimate goal, though, is to be the director of an OR.”

Through the 23 years she’s worked in the industry, Rotonya has developed a good understanding of medical matters. That’s why she became concerned when complications arose following the birth of her son in 2015. Her problems were related to uterine fibroids, benign growths in the uterus that began to form while she was pregnant.

“The fibroids caused my stomach to grow very large and made my pregnancy high-risk,” Rotonya describes. “My belly was so big I could barely walk, drive or do anything. After I gave birth, my doctor tried to shrink the fibroids with Depo-Provera®, which contains the hormone progestin. But once I went off the Depo, the fibroids grew back even larger.

“My stomach became so big that I looked six months pregnant, when I wasn’t. I couldn’t wear clothes with buckles or buttons; I could only wear dresses and skirts with elastic waists. I couldn’t lie on my stomach, and there was a lot of pressure in my chest from my organs being moved around.

“Sometimes, I got sharp pains that felt like labor contractions. The pain was so bad I would ball up into a fetal position. There were days I couldn’t get out of bed. My stomach often felt full. Eating an apple felt like I ate a full-course meal. I had terrible heartburn as well. I went through an entire bottle of antacid a week. And I was constipated. It was a very uncomfortable life.”

Rotonya wasn’t content with the treatment her doctor was proposing, which included a hysterectomy, the surgical removal of her uterus. Then, she heard about an alternative procedure called uterine fibroid embolization offered at Interventional & Vascular Center in Melbourne.

“I was in a doctor’s office and saw a brochure about fibroid embolization,” Rotonya remembers. “I inquired about it and learned that it’s a new procedure. My doctor didn’t know much about the biology of it, so I was hesitant about pursuing it. Then I spoke to Dr. Kennedy, and he walked me step-by-step through the procedure.”

Robert J. Kennedy, MD, is a board-certified vascular and interventional radiologist at Interventional & Vascular Center. Dr. Kennedy and his partner, board-certified vascular and interventional radiologist Brian L. Dunfee, MD, use minimally invasive, image-guided techniques to treat conditions such as uterine fibroids. Embolization is one of those techniques.

“Rotonya came to us for an opinion about treatment for symptomatic uterine fibroids,” Dr. Kennedy recalls. “She was experiencing increasing pelvic pain and girth in her lower abdomen as well as heavy menstrual periods lasting longer than the usual five days. Imaging revealed she had a large fibroid measuring over 10 cm, or about the size of a cantaloupe.

“Rotonya had already tried conservative management with hormonal therapy, but her symptoms continued to get worse. She had also consulted a gynecologist who recommended a hysterectomy, but she wanted to explore other options. We suggested uterine fibroid embolization, and she agreed to pursue it.”

Endovascular Technique

Uterine fibroid embolization is an endovascular procedure, meaning it is performed through the blood vessels.

“Uterine fibroids are highly vascular tumors,” the doctor informs. “They rely on a rich supply of blood from the uterine arteries to survive. The goal of fibroid embolization is to essentially starve the fibroids by cutting off their blood supply.”

During fibroid embolization, doctors insert a long, skinny tube called a catheter into an artery in the groin or wrist. Under fluoroscopy guidance, the doctors navigate the catheter through the arterial system into the uterine arteries, where they inject small gelatin-polymer microspheres.

“These microspheres travel through the uterine arteries and lodge into the arteries’ terminal branches, effectively plugging the arteries and blocking blood flow to the fibroids,” Dr. Kennedy educates. “Without a blood supply, the fibroids are starved of the oxygen and nutrients they require to grow, and they begin to shrink.”

“My stomach has returned to its normal size. It hasn’t been this flat since 2015.” – Rotonya

While hysterectomy is 100 percent effective at resolving uterine fibroid symptoms, there is a significant risk for complications from the surgery as well as a long recovery period. Fibroid embolization is much less invasive and nearly as effective at resolving the uncomfortable symptoms of uterine fibroids without the associated risks.

“About 95 percent of patients treated for bleeding achieve resolution of their symptoms with fibroid embolization,” Dr. Kennedy reports. “For patients with bulk-related symptoms, such as pelvic pain and pressure, embolization is a little less effective. It resolves the symptoms in about 85 to 90 percent of cases.

“If a patient undergoes fibroid embolization and does not achieve the desired outcome, it does not preclude other treatment options, such as hysterectomy or myomectomy, the surgical removal of individual fibroids, in the future.”

“Summer Ready”

Dr. Kennedy performed Rotonya’s fibroid embolization on March 21. When the surgical tech experienced heavy bleeding immediately following the procedure.

Dr. Kennedy assured her it was simply a result of her fibroid losing its blood supply.

“After 10 days, the bleeding stopped. For about a week, I had no symptoms whatsoever,” Rotonya enthuses. “Then, after four weeks, I had a menstrual period, but it wasn’t as heavy as before.”

“Now, I feel wonderful. I feel summer ready. I’m back to wearing my normal clothes, including shorts and clothes with buttons. My stomach has returned to its normal size. It hasn’t been this flat since 2015.”

Rotonya gives kudos to Dr. Kennedy and his staff.

“Dr. Kennedy is awesome,” she raves. “He’s very knowledgeable, and he reassured me from the minute he walked into the room. Everything I asked, he was willing to answer. And his office staff is amazing. After the procedure, they were on the phone with me every other day asking, Are you OK? How are you feeling?

“Everyone at Interventional & Vascular Center made me feel welcomed. They did whatever they could to make me comfortable. My experience was awesome!”

© FHCN article by Patti DiPanfilo.Photo courtesy of Rotonya Browder. mkb
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