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Elected by his peers for inclusion in The Best Doctors in America® 2011-2021.
Hi, I'm John Thomas, MD. Welcome to my website.
It's mostly about UFE for fibroids, though I discuss some other procedures that we offer at Methodist Hospital in San Antonio.
Fibroids? UFE?
Fibroids are benign tumors of the uterus. Benign means they do not behave like a cancer and spread to other parts of the body. That's the good news. The bad news is fibroids can cause a lot of misery.
They can cause heavy abnormal menstrual bleeding. So much bleeding that patients with them are often anemic. When you are anemic you have low energy, feeling tired all the time. Fibroids are a common cause of pelvic pain. Sex can be painful because of the fibroids.
Fibroids can press on the bladder making you feel like you have to pee all of the time. And they can press on the rectum, causing constipation and bloating. They can make your abdomen stick out as if you were pregnant.
A classic treatment for fibroids is surgical removal of the uterus: hysterectomy. But a much less radical, highly effective, non-surgical treatment is Uterine Fibroid Embolization (UFE)
UFE is a medical procedure; not some iffy alternative therapy. The procedure is performed in a hospital by sub-specialty trained physicians. UFE is safer than hysterectomy, has a shorter recovery time and will get rid of the fibroids without the need for surgery. If you are suffering from fibroids and trying to avoid surgery UFE might be your solution. And if you are considering hysterectomy, you would be well served to read the rest of this page before you decide.
They can cause heavy abnormal menstrual bleeding. So much bleeding that patients with them are often anemic. When you are anemic you have low energy, feeling tired all the time. Fibroids are a common cause of pelvic pain. Sex can be painful because of the fibroids.
Fibroids can press on the bladder making you feel like you have to pee all of the time. And they can press on the rectum, causing constipation and bloating. They can make your abdomen stick out as if you were pregnant.
A classic treatment for fibroids is surgical removal of the uterus: hysterectomy. But a much less radical, highly effective, non-surgical treatment is Uterine Fibroid Embolization (UFE)
UFE is a medical procedure; not some iffy alternative therapy. The procedure is performed in a hospital by sub-specialty trained physicians. UFE is safer than hysterectomy, has a shorter recovery time and will get rid of the fibroids without the need for surgery. If you are suffering from fibroids and trying to avoid surgery UFE might be your solution. And if you are considering hysterectomy, you would be well served to read the rest of this page before you decide.
Here are two helpful videos about UFE.
The first is an
interview with KSAT 12 reporter Ursula Pari.
It's from 2012, but all of what is said is still relevant in 2021.
UFE is called "New" in this interview.
That is incorrect; we started performing UFE in 1999; 13 years prior to this interview.
What was "New" about UFE in 2012 was the nerve block we started using.
The block has been the most important advance in the procedure since 1999; changing it from a procedure some women called more painful than childbirth to a procedure that only causes some discomfort; nothing you need to stay in the hospital for.
The second video was produced by Merit Medical, the company that makes the Embospheres we use for UFE
I will be the first to say that their 3D animation of the uterus is kind of creepy. But it is instructive if you can get past it.
Note, in the video they show a small incision made at the top of the leg. In the video it looks pretty big, in reality it is the size of a pencil point. Another thing the narrator says is that there is no scar tissue. She means on the outside you will have no scars (like you get with an abdominal hysterectomy). After UFE the fibroids convert to scar tissue when they die but those are scars within the uterus.
Uterine Fibroid Embolization
The first is an
interview with KSAT 12 reporter Ursula Pari.
It's from 2012, but all of what is said is still relevant in 2021.
UFE is called "New" in this interview.
That is incorrect; we started performing UFE in 1999; 13 years prior to this interview.
What was "New" about UFE in 2012 was the nerve block we started using.
The block has been the most important advance in the procedure since 1999; changing it from a procedure some women called more painful than childbirth to a procedure that only causes some discomfort; nothing you need to stay in the hospital for.
The second video was produced by Merit Medical, the company that makes the Embospheres we use for UFE
I will be the first to say that their 3D animation of the uterus is kind of creepy. But it is instructive if you can get past it.
Note, in the video they show a small incision made at the top of the leg. In the video it looks pretty big, in reality it is the size of a pencil point. Another thing the narrator says is that there is no scar tissue. She means on the outside you will have no scars (like you get with an abdominal hysterectomy). After UFE the fibroids convert to scar tissue when they die but those are scars within the uterus.
Uterine Fibroid Embolization
While UFE is not performed by gynecologists, their professional society determined a decade ago that it is safe and effective for women who don't want surgery:
UFE is "safe and effective"*
American Congress of Obstetrics and Gynecology (ACOG)
* Please note, UFE is not ideal for every woman. It is a procedure that has known complications just like any other medical procedure. I can help you decide if UFE is right for you.
Most women to go home a few hours after UFE!
We used to keep all of our UFE patients overnight in the hospital for pain control. A decade ago we adopted a nerve block; a method to temporarily decrease the sensation in the pelvis after UFE, similar to how the dentist numbs your mouth before a procedure. This simple and safe modification has made an impressive difference...most women have only moderate discomfort, a pressure sensation in the pelvis, after UFE and can go home a few hours after the procedure.
Here are some positive things my patients had to say after UFE
"Everything you said would happen following the procedure, did. I wasn't surprised at anything...Thank you again for being so thorough and honest. You rock." -Alexandra
"Uterine fibroid embolization...has changed my life in so many positive ways and I still have the possibility of having children in the future."-Lori
"Everything you said would happen following the procedure, did. I wasn't surprised at anything...Thank you again for being so thorough and honest. You rock." -Alexandra
"Uterine fibroid embolization...has changed my life in so many positive ways and I still have the possibility of having children in the future."-Lori
Other opinions on UFE
I am a big proponent of UFE because I see how well it works for my patients. But you don't need to take my word for it. For an objective review of treatment options for fibroids, please see Information for Patients on treatment options for Fibroids on UpToDate.com
UpToDate is "...one of the most respected medical information resources in the world, used by more than 600,000 doctors and thousands of patients to find answers to medical questions"
Here is an article from US News and World Report about a woman who almost had a hysterectomy in 2018. She saw 5 gynecologists and all of them recommended hysterectomy without mentioning UFE as an option. She did her homework and discovered UFE.
Boston Scientific, one of the major medical device manufacturers in the US, launched their site on the benefits of UFE in 2017.
It's called Freedom From Fibroids. There are a few well done videos of women who were trying to decide what to do about their fibroids and why they chose UFE.
My professional society, the Society of Interventional Radiology, has a site called The Fibroid Fix that has a lot of information of fibroids and UFE.
WebMD has an article on UFE. Unfortunately, they chose a Gynecologist to be the specialty medical reviewer on the topic without balancing those opinions with an Interventional Radiologist, so it is quite biased against UFE.
There are many inaccurate statements, and twice they refer to a study where 1 in 5 women had to go on to have another procedure after UFE. That study has the lowest success rate of any study in the medical literature; yet they refer to it twice...this should give you a sense as to how biased their specialty medical reviewer is against UFE.
UpToDate is "...one of the most respected medical information resources in the world, used by more than 600,000 doctors and thousands of patients to find answers to medical questions"
Here is an article from US News and World Report about a woman who almost had a hysterectomy in 2018. She saw 5 gynecologists and all of them recommended hysterectomy without mentioning UFE as an option. She did her homework and discovered UFE.
Boston Scientific, one of the major medical device manufacturers in the US, launched their site on the benefits of UFE in 2017.
It's called Freedom From Fibroids. There are a few well done videos of women who were trying to decide what to do about their fibroids and why they chose UFE.
My professional society, the Society of Interventional Radiology, has a site called The Fibroid Fix that has a lot of information of fibroids and UFE.
WebMD has an article on UFE. Unfortunately, they chose a Gynecologist to be the specialty medical reviewer on the topic without balancing those opinions with an Interventional Radiologist, so it is quite biased against UFE.
There are many inaccurate statements, and twice they refer to a study where 1 in 5 women had to go on to have another procedure after UFE. That study has the lowest success rate of any study in the medical literature; yet they refer to it twice...this should give you a sense as to how biased their specialty medical reviewer is against UFE.
If you are still reading you must be interested. So please take a few more minutes and explore my web site. Let me know if you have any questions!
- John W. Thomas, MD FACR
"The weight of my uterus was unbearable, pregnancy was more comfortable! I developed large painful varicose veins, back pain, my clothes didn't fit, my personal life was tanking and I was losing bladder control."- Celia
