Uterine Fibroid Embolization (UFE) Cost in India

Signs and symptoms 

Females with infertility problems are also evaluated for uterine fibroids 

Diagnostic tests  

• Ultrasound
• Complete blood count to detect any abnormal blood loss or bleeding disorder 
• Thyroid tests 

Other imaging tests 

• Hysterosonography ( transvaginal ultrasound )
• Hysterosalpingography (radiologic procedure to investigate the shape of the uterine cavity)
• Hysteroscopy (cervix and uterus is examined by inserting a lighted tube)

Classification of uterine fibroids 

• Subserosal: Fibroid is projecting outside the uterus
• Intramural: Fibroid is present within the myometrium ( it is the middle layer of the uterine wall) 
• Submucosal: Fibroid is projecting into the uterine cavity

TREATMENT OPTIONS

It should be done depending upon the size and location of fibroids; the patient's age, symptoms, desire to maintain fertility, and access to treatment; and the experience of the physician. 
 

Nonsurgical 

Gonadotropin-releasing hormone agonist (An agonist is a chemical substance which after binding to a receptor, activates it to produce a certain response, an agonist causes action and antagonists blocks its action)

• It is a pre-operative treatment modality to decrease the size of tumors before surgery or in women approaching menopause.
• It decreases blood loss.
• Have shorter operative time and less recovery time.

Levonorgestrel-releasing intrauterine system 

• It treats abnormal uterine bleeding, likely by stabilization of endometrium (inner epithelial layer of the uterus).
• It is the most effective medical treatment for reducing blood loss. 
• It decreases fibroid volume.

Nonsteroidal anti-inflammatory drugs

• These are anti-inflammatories and prostaglandin inhibitors.
• These drugs reduce pain and blood loss from fibroids.
• These do not decrease fibroid volume.

Oral contraceptives

• These treat abnormal uterine bleeding, likely by stabilization of endometrium.

Tranexamic acid: It decreases heavy mensural bleeding caused by large fibroids. 

Antifibrinolytic therapy: It reduces blood loss before surgery in the case of myomectomies and reduces menorrhagia (prolonged vaginal bleeding in a mensural cycle ) in patients with fibroids.

Surgical therapies

Before undergoing surgery other than ultrasound MRI (magnetic resonance imaging) is also advised.

Surgical removal of the uterus: It is a definitive treatment for women who do not wish to preserve fertility. Done via three approaches Trans-abdominally, Trans-vaginally and laparoscopically.

• Transvaginal and Laparoscopic approach associated with decreased pain, blood loss, and recovery time compared with transabdominal, surgery morcellation with laparoscopic approach increases the risk of iatrogenic dissemination of tissue.
• Surgical risks higher with Transabdominal surgery (e.g., infection, pain, fever, and increased blood loss and recovery time). 

Magnetic resonance-guided focused ultrasound surgery 

In-situ destruction by high-intensity ultrasound waves. It is a non-invasive approach and has shorter recovery time with modest symptom improvement.

Myomectomy

Surgical or endoscopic excision of tumors, Resolution of symptoms with preservation of fertility.

Uterine artery embolization

Interventional radiologic procedure to occlude uterine arteries. It is a minimally invasive procedure and is used as an alternative to surgery and requires a short hospitalization period.