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October 5, 1999
ABC Good Morning America
Uterine Artery Embolization for Fertility Retention

Diane Sawyer

This is a condition that affects a lot of women--one in four American women--causing tremendous pain and forcing many of them to make a painful choice.

For years the only real cure for benign tumors of the uterus called fibroids was to remove the uterus itself. In fact that's the most common reason in the past behind the 600,000 hysterectomies performed each year in the U.S.

But in today's "healthy woman," medical correspondent Nancy Snyderman has a report on a brand new treatment that can make options more possible.

Nancy Snyderman

39-Year-old Leslie Miles is the first woman in the world to do what doctors had thought impossible. The first to have a baby after an amazing new treatment for fibroids. A treatment that spared her uterus even though her symptoms were severe.

Leslie Miles

You're irritable, you’re fatigued all the time. I was so bloated that I looked four or five months pregnant. I was having periods every two weeks. With heavy bleeding and heavy clotting.

Nancy Snyderman

Leslie's fibroids, benign tumors that grow in or on a woman's uterus, gave her many of the classic symptoms.

Besides the bleeding problems, fibroids can cause pain in the abdomen or lower back and during sex. And their size can create pressure, causing even more problems. Like difficulty urinating, frequent urination, and constipation.

Until now, hysterectomy was the treatment of choice. It's 100% curative but the cost is a woman's fertility.

Leslie Miles When I left the doctor's office I was crushed at that time, you know. And thinking but, well, if this is what we got to do, this is what we got to do. I can't go on living, you know, like this.
Nancy Snyderman Leslie had already decided to have the hysterectomy when she heard of a doctor at UCLA, Dr. Scott Goodwin and a pioneering procedure that would allow a woman like her to avoid surgery and still treat the fibroids. He calls it uterine artery embolization and he says it works.
Scott Goodwin Well, in at least 85% of our patients after embolization we're hearing that these women are having very significant improvements in their symptoms and very frequently resolution of their symptoms.
Nancy Snyderman

Since its introduction in 1996, over 6,000 women worldwide have opted for this new alternative to hysterectomy to treat their fibroids.

In a hospital x-ray room, a thin catheter is inserted into the groin.

Using x-ray guidance, a doctor threads it into two arteries that supply the uterus and the fibroids with blood. Then comes the surprising part. Doctors use the catheter to inject small plastic particles into the arteries causing the blood to clot. With no blood supply to feed it, the fibroid slowly starves and begins to shrink.

Leslie was one of the first women in the United States to have this procedure. And she saw an improvement in her symptoms almost immediately.

Leslie Miles I got relief from it, from all of those symptoms that I had had for the last 10 years the very next month.
Nancy Snyderman And then the reason she had been desperate to save her uterus, five months after her procedure, she became pregnant with the baby girl she had given up hoping for.
Leslie Miles I was just overjoyed you know. And then when she opened her eyes and looked at me for the first time, that was just unbelievable.
Nancy Snyderman Almost a year to the day she decided to look for an alternative to hysterectomy, Leslie and her husband Jim and 16-year-old daughter Rianna look forward to the life ahead with a very special new edition.
Leslie Miles I could have had a hysterectomy and none of this would ever have happened. It’s so much better that I did have this other procedure and that we did get to experience the joy of having another child.
Diane Sawyer How cute. Dr. Nancy Snyderman joins us now from San Francisco. So what causes fibroids in the first place, Nancy?
Nancy Snyderman

We don't know, really. We know it is under hormonal influence, especially during certain times of a woman's life after the age of 40 when estrogen and progesterone are changing.

These tumors can really grow to such significance that you can appear pregnant as the woman in the story said. She looked like she was five months pregnant. So, there is a hormonal base even if we don't understand precisely what triggers them.

Diane Sawyer And which women can avail themselves of this procedure, with whom does it work?
Nancy Snyderman

I think it's really important to look at yourself and your child bearing years. For instance, those of us who perhaps have had all of the children we're going to have, a hysterectomy may sometimes be the real treatment of choice.

But this procedure is intended for women who want to spare the uterus.

And until now women who’d want to keep their uteruses but still had to get rid of the fibroids had to undergo other kinds of operations that still had a pretty high sterility rate.

The advantage of this is it allows you to forego major surgery, keep your uterus, have the procedure to get rid of the fibroids, and then still have a pretty good chance of preserving the lining of the uterus. And it's the lining of the uterus that is crucial to the implantation of sperm and egg if you want to go ahead and have a baby.

Diane Sawyer If this doesn't work, there is still a drug option as opposed to hysterectomy, right?
Nancy Snyderman There are medications on the market. And depending on who you talk to, they either work really well or they make women sort of crazy. They cause these huge hormonal fluctuations. But there are hormones, nonetheless. And there is also a perhaps a way of freezing them, too.
Diane Sawyer All right. Thank you.

UFE Conference '99Uterine Fibroid Embolization


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