Uterine fibroids, which are benign tumors in the muscle of the uterus, are one of the most common problems in women of child-bearing age. Up to 70 percent of women -- and 80 percent of African American women -- have fibroids. The cause is unknown, though some are hereditary.

For some women, fibroids cause serious health problems, including severe menstrual bleeding, pelvic pressure, constipation, lower back pain, painful intercourse and infertility. Fibroids usually cease to be a problem when a woman reaches menopause.

A large number of the nearly 600,000 hysterectomies performed in the United States each year are for the relief of symptoms caused by fibroids. Women who want to have children sometimes opt for a myomectomy -- a surgical procedure in which the fibroids are cut out but the uterus remains intact. Drug therapy also is sometimes used.

Dr. James F. Benenati, medical director of Baptist Cardiac & Vascular Institute's Peripheral Vascular Laboratory, was among the early practitioners to use a technique called uterine fibroid embolization, which cuts off blood to the fibroids, effectively killing the growths. The technique is not major surgery but a less-invasive procedure in which a catheter is threaded through an artery in the groin.

The procedure is done by an interventional radiologist, a doctor who specializes in minimally invasive procedures.

In its August 2008 practice bulletin, the American College of Obstetricians and Gynecologists declared uterine fibroid embolization ``a safe and effective option'' for treatment of fibroids. The college advised using the treatment with caution on women who want to become pregnant, saying further study is needed.

We talked to Benenati about using uterine fibroid embolization as a treatment. His answers have been edited for space.

Q: What is uterine fibroid embolization?

A: About 12 years ago, a number of physicians started treating fibroids with embolization, which is a nonsurgical procedure done through a small catheter, and this has proven to work quite well.

The procedure is a non-invasive, nonsurgical procedure that involves placing a very thin tube, about as thick as a piece of string or a piece of spaghetti, into an artery in the groin. From there we use very low-dose X-rays and we steer the catheter into the arteries that feed the uterus on the left side and the right side.

Once we're in those vessels, we inject very small particles, like grains of sand, synthetic particles that are completely inert. Patients don't have reactions, there are no allergies to those particles. Those particles clog up the blood vessels and kill the blood supply to the tumors. They shrink and patients' symptoms get better. After we do the procedure, it can take up to three months before you start seeing very good results. Usually by about the seventh month, you're about as good as you're going to get.

Q: What is the recovery period?

A: Some patients actually go home the same day and many patients stay over one night. We ask most women to take about a week off work. But the procedure itself can cause some inflammation that can cause abdominal pain and cramping, and it takes about a week to run its course. The women that we treat are usually back to work with a completely normal lifestyle by the end of the week.

Q: Is this procedure appropriate for women who want to get pregnant?

A: Women who still want to get pregnant have to really think about their options. Clearly hysterectomy is a very bad option; there's no chance of pregnancy. A myomectomy is a good option because you'll keep your uterus.

With embolization, for many years we weren't sure what would happen with pregnancy afterward. But we have a number of women in our own practice and we have a number of reports of women going on to have normal uterine pregnancies. There have been some papers recently showing that it is relatively safe. Myomectomy is good when you have one or two very large fibroids. But if you have four or five fibroids, myomectomy isn't good, and if you want to preserve your fertility, this is really the only option women might have. We do this in women who want to get pregnant, but we are a bit cautious and we always warn them we're not 100 percent sure what may happen down the road.

Q: Are there women for whom this is the best choice and women for whom it is not?

A: About 75 percent of the women we see, this is a good choice for. About 25 percent of the women we recommend back for either a myomectomy or hysterectomy. Sometimes if the fibroids are too big, we can't treat them. Q: Why isn't this procedure more widely used?

A: One reason this hasn't been well received is it's often hard to get the information to the patients. For a long time, until we had a lot of data, the procedure was viewed as a new and somewhat evaluational procedure and, rightfully, some people were reluctant to endorse it. But over the past few years there have been enough very well-done studies where they compare embolization with hysterectomy and myomectomy, and it stacks up quite well. It should be viewed as a mainstream procedure. It should be offered to women who are looking for a choice.

Health Q&A runs every other week.

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