Selected Podcast
Treatment of Fibroids and other Benign Uterine Conditions via Uterine Artery Embolization (UAE)
Dr. Theresa Caridi discusses UAE, who a good candidate for UAE would be, and common misperceptions about UAE for fibroid disease.
Featuring:
Learn more about Theresa Caridi, MD
Theresa Caridi, MD
Theresa Caridi, MD, FSIR, is an Associate Professor and the Division Director of Vascular and Interventional Radiology at the University of Alabama at Birmingham (UAB). After attending the University of Florida for medical school and radiology residency, Dr. Caridi completed a fellowship in Vascular and Interventional Radiology at the University of Pennsylvania. The first seven years of her career were spent at Georgetown in Washington, D.C., before joining the faculty at UAB.Learn more about Theresa Caridi, MD
Transcription:
Dr. Huh (Host): Hello, this is Dr. Warner Huh, the Chair of Obstetrics and Gynecology at the University of Alabama, Birmingham. And I'd like to welcome to this monthly episode of Women's Health with Dr. Huh. Today, we're going to be discussing a truly practical important topic, and there perhaps isn't more cutting edge in women's health and the topic of uterine artery embolization. And with us today is Dr. Theresa Caridi, who is the Director and Associate Professor in the Division of Vascular and Interventional Radiology, and also serves as Vice-Chair of Interventional Affairs in the Department of Radiology. Some of our listeners may be already familiar with this topic, but the reason we're discussing this today is really, it's importance in terms of the modern management of uterine fibroids and symptoms related to that. So Dr. Caridi is a true expert in this area. She has performed thousands of these procedures and we were lucky to recruit her from Georgetown University and welcome Dr. Caridi.
Theresa Caridi, MD (Guest): Thank you, Dr. Huh. It's a real pleasure to be here. I'm so grateful for the opportunity to speak with you today.
Host: So, I know that you have, I have significant familiarity with uterine fibroids and, you know, obviously it's a highly common problem, but I thought maybe you might want to comment for our listeners on just the general incidence and prevalence and symptoms and treatment options related to fibroids.
Dr. Caridi: Absolutely. Uterine fibroids are extremely common in the female population. In fact, about 70% of Caucasian women and 80% of black women have uterine fibroids by the age of 50. Now, not all of those women experience symptoms related to their fibroids. So, about half of those women have symptomatic uterine fibroids. So, some of those symptoms include heavy menstrual bleeding or long cycles. They can also have bulk symptoms. So, bloating or urgency to go to the bathroom frequently or even constipation. They can have pelvic pain and there are several treatment options for these symptoms. One is to do nothing, of course, it's a benign condition, so they don't have to be treated. But there are various treatment options and therapies, depending on a woman's preferences. Some of those include medications to mitigate the symptoms. You can have a definitive treatment with hysterectomy, which removes the uterus of course, more in your territory.
You can have individual removal of fibroids via myomectomy if you're the appropriate candidate, or you can undergo something like uterine fibroid embolization, or uterine artery embolization for fibroids, which is a minimally invasive procedure that doesn't require a surgery but treats the fibroids globally all at the same time in a similar sense to a hysterectomy although it leaves the uterus behind.
Host: Yeah. So what I'm hearing is that really uterine artery embolization is really the ultimate form of minimally invasive treatment for fibroids. And it's interesting because for years, you know, the only treatments that we had were birth control pills or myomectomy, or even hysterectomy. And it's interesting how UAE or uterine artery embolization has become sort of a mainstay of therapy over the last several years. Could you describe to the listener what exactly is uterine artery embolization? Some of our listeners may not be familiar with the actual technique.
Dr. Caridi: Absolutely. Uterine artery embolization, and sometimes you'll hear it referred to as uterine fibroid embolization specifically when it's for the treatment of fibroids. But this procedure is essentially a way that we go in and block the blood supply to the fibroids. And when you starve the fibroids of their nutrients and oxygen by blocking their blood supply, that makes the fibroids essentially die for lack of a better word.
And so they can no longer cause the symptoms that they were previously causing. We don't remove anything. The incision for this procedure is a few millimeters and in fact just essentially needs a glorified band-aid on top of it before discharge that day. We use in order to treat the fibroids and block their blood supply, we use a tiny catheter that goes inside the vessel, either in the upper leg or in the wrist. It's very similar if you've heard about heart catheterizations, when you think about, the little catheter that is used for that, it's on a few millimeter scale. That's very similar to what we do with uterine fibroid embolization.
Host: So, can you comment on a little bit like who are candidates for this kind of procedure? You know, who would, you know, if they were to come to you and you're like, oh, you'd be a great candidate for this. I mean, who are those people?
Dr. Caridi: Ideally, women with fibroids should get a consultation with both a gynecologist and an interventional radiologist, because in reality, all women are potential candidates for any therapy and really need to talk to an expert about the nuances of the ideal treatment for them. There are some patients who wouldn't be ideal for a uterine artery embolization, and those include women who are either of course, actively pregnant or have an active infection.
And then there's the gray zones. Those women who might want future fertility, they kind of fall into a gray zone and we can talk a little bit more detail about that. One of the other areas that I consider a bit of a gray zone is very dependent on the fibroid location. And so it's not that a woman cannot undergo uterine artery embolization if their fibroid is for instance, in a location within the endometrial canal, which is where baby is grown during pregnancy.
If a woman has a fibroid in that location, there is some increased risks to doing a uterine artery embolization that need to be discussed in consultation. And it may not be the optimal choice for that patient. But every patient is unique and every fibroid is unique. And so that discussion really needs to happen in a consultation.
There's also fibroids on the outside of the uterus and those are called subserosa fibroids. We can also treat those via uterine artery embolization. However, if a woman is seeking a certain outcome, for instance, if she comes and says, I would like a cosmetic result of my abdomen or pelvis to not feel this enlarged, I have to counsel that patient, that we may not achieve the degree of volume reduction of that fibroid that they may want. So, those are the gray zones that we need to have further conversation about it in clinic.
Host: You were getting into the issue of risks. So what are the actual known risks of an embolization procedure like this one?
Dr. Caridi: One of the more common things that happens with any embolization procedure in some patients who undergo embolization is something known as post embolization syndrome. So, women can feel kind of flu like for, even up to a week after embolization. And that's from all the inflammation that is caused by taking away that blood supply to the fibroids.
Other things that can happen after embolization, and probably one of the larger things that make women consider this versus other options is uterine artery embolization can be painful and it's kind of an accelerated recovery. So, it's not a lengthy recovery, like might be for an open surgery.
However, you get a lot of inflammation and pain that first evening after the procedure in most patients. And so it's a bit of an accelerated recovery, by the next day, things are much, much better. And usually women only need a few days to recover from a uterine artery embolization. Now, when I discuss this in clinic with a patient, I usually recommend that they take a week off work and plan for a week because in the extreme circumstances, there are women who need a full week to recover.
Host: So, I'm going to take you up on your comment in this gray zone or future fertility. So, I am sure that we have a lot of listeners who have symptoms related to fibroids, whether it's pain, bleeding, et cetera, but they're very much interested in preserving their future fertility. I wonder if you can comment on that?
Dr. Caridi: Absolutely. As you can imagine, this is a very difficult area to study. Women who are candidates for fibroid embolization or other fibroid treatments are usually not in the ideal years for fertility as it is. So, they may have other reasons to have fertility challenges, often they're in their forties and not in the optimal years for conceiving.
So, when you look at these A studies, that have allowed patients who want to conceive to undergo either uterine artery embolization or another fibroid treatment. It's very challenging to look at those rates and know whether it's the procedure that impacted their ability to get pregnant, or the fact that they were not at their optimal fertility years to begin with.
However, one of the other challenges with it is do we compare uterine artery embolization to the gold standard, which is hysterectomy. We can't do that if we're talking about fertility or do we compare it to myomectomy, which is another somewhat minimally invasive way to treat fibroids. And that's typically what's done of course, because that preserves a uterus similar to uterine fibroid embolization.
I think in reality, if you look at the data, the most recent data is from the Femme Trial, which was published last year. And that shows that the pregnancy rates were very similar and delivery rates were very similar. In fact, no difference. But again, the studies are very difficult to do. And I think if someone were to ask me if I would suggest this procedure to a family member or myself or any woman who is desiring future pregnancy, I would say let's explore your other options first.
I think there's some impact probably on fertility when you do global embolization of the uterus. Similarly, I think there are some impact when you do myomectomy of the uterus and make incisions on the uterus to remove the fibroids. So, it's not ideal, but there are certain circumstances where a woman doesn't have any other options and her quality of life is so poor from her fibroids that she may opt to undergo either a uterine fibroid embolization or a myomectomy with the right counseling.
Host: Yeah. I mean, I'll take that one step further. You know, as a surgeon who obviously operated on thousands of women with really significant fibroids, it's remarkable to me how this procedure in and of itself has improved the quality of life of women, and we have a lot of women who are not surgical candidates for whatever reason, and this is their last resort and it's remarkable how much it's turned their life around. It's it's impressive.
Dr. Caridi: I agree. Obviously I'm a little biased, but it's something that I've been really passionate about for several years. And in fact, where I trained at Penn, I thought it was going to be segueing more into the interventional oncology space, but I was exposed to the treatment of uterine fibroids from some of my mentors and I was so moved by seeing these women back in clinic and the experience they had and the significant degree of symptom reduction without having a surgery. And so it was really that experience that led me to get so passionate about it and really focus a lot of my career towards women's health within the interventional radiology space.
Host: So can you comment, for the listeners, what's the expected recovery after an embolization procedure? What can an individual expect?
Dr. Caridi: The expected recovery is, as I mentioned before, it's very accelerated in that first evening. It can be a challenging night to be honest with you. And most of the time, by the time of discharge later that day, a woman is doing well enough to care for herself. However, on occasion, we do keep a woman one night in the hospital, just depending on their level of pain control. Usually a woman recovers in what I consider a long weekend. However, some women require up to a week. That's a bit unusual, but it can happen. And so I tend to tell women to plan for a week of recovery, take that week off work and that way, if they need that full week, they have it. But in general, I would say most women recover in sort of a long weekend type timeframe.
Host: Why should women consider coming to UAB for this type of treatment? Is there something that's unique about the program that we have here that makes UAB best suitable to provide this kind of care?
Dr. Caridi: One of the things I like about the care at UAB in the gynecologic space, is that we can offer all of the possibilities to a woman for her care. And it may be such that she already has a relationship with a gynecologist elsewhere. And that's okay. There's no harm in getting a second opinion or hearing other options beyond maybe a hysterectomy. Here at UAB, we're really able to give the full spectrum of care and we're sub-specialized in such a way that for instance, even though I'm within interventional radiology, this is a passion area of mine that I spend a lot of time pursuing the literature, the technique and research related to this subject matter. And those same experts exist here for gynecology, of course, and specific to fibroid treatments. So, I think one of the reasons is that you can get the spectrum of opportunities here for fibroid treatment.
And another, is the way that we can work together. So, we're able to collaborate well. The fact that you have me on this podcast, I think is evidence of that. Some might consider our procedures and what we're able to offer as competing procedures or competitive. But we are really looking out for a woman's best interest and wanting to pursue any possibility that might be the best treatment option for her.
Host: I'm going to make a statement and I'm assuming that you probably agree with it, that in my experience, uterine artery embolization is best utilized in sort of a coordinated care setting and that it's never done well in isolation or siloed off. And I think that the programs that best do this, do coordinate their care with the gynecologists and the surgeons to make sure that we provide these options. That, and a lot of it is just awareness. The neat thing about this is that we see it as a very important treatment option for our patients and it's very front and center. And I'm grateful that we have the ability to provide that service st UAB.
Dr. Caridi: I absolutely agree with you. I feel very fortunate to be here and to be able to work collaboratively with everyone here. That's not something that exists everywhere and it's a real benefit of being at UAB.
Host: So, how does one make a consultation with you and your team? Can you let the listeners know how that process works?
Dr. Caridi: Just like most services at UAB, we have an interventional radiology clinic, so, women can either come via their gynecologist, or they can self-refer. One of the benefits, again, of being here and being able to work collaboratively, is, if a woman comes as a self-referral, we can plug her into someone here, a second opinion here with gynecology, or if they're seeking more advanced care that they're not able to get where they are in their local community, that can be another reason why we may plug them in here. So, there's lots of ways in which they may get to us. It may be from a gynecologist here, from a gynecologist elsewhere. Or potentially just self-referred to hear more about uterine artery embolization to our interventional radiology clinic. We actually have a separate number that goes straight to our clinic coordinator and she's a nurse and she can triage what might be the best way that woman gets to see us.
And usually that'll just be with a clinic visit. Fortunately, one of the positives that came out of COVID is the ability to use Telehealth as well. So, we are still utilizing Telehealth because a lot of what we're going to discuss can happen actually over a video call. We also have some new endeavors that are reaching out into even further areas of Alabama that are considered quite rural.
And we've set up an opportunity at Whitfield Regional Hospital, actually, where a woman can come to Whitfield and utilize their facilities. There's a room that's already set up where they can be broadcast to us in our interventional radiology clinic and talk about this procedure with us and receive that formal consultation without ever having to make the trip up to UAB.
So, this only exists at Whitfield Regional right now, but we're potentially going to be expanding to other rural areas of Alabama. So, there's many opportunities whether in person or via Telehealth.
Host: That's awesome. That's incredible. Any parting thoughts or comments related to the procedure and the care that we provide, Dr. Caridi?
Dr. Caridi: I think instead of making it even specific to uterine artery embolization, I think what's most important is that women should realize that this disease process runs in families and what they may perceive their grandmother had to have an open hysterectomy in order to treat this disease process. You know, I want women to realize there are many options and they can seek those out and hear about them and see if one might be right for them. And we offer all of those at UAB. So, it's a great place to get that consultation and care. And also, the subject in general about uterine fibroids and heavy bleeding is in the past has kind of been a bit of a taboo topic, but honestly there's no reason at this point to really live with that poor quality of life when there are so many options, and we should be able to speak about it.
Host: No, I totally agree. So, in summary, I think for the listeners, uterine fibroids as mentioned earlier is really perhaps the most common benign tumor that we see in women. I mean, there are millions and millions of women that have this, and we particularly see an increased incidence in the Southeast area. But I think more importantly, that the number of treatment options that we have for patients has grown. And we used to live in an era where only hysterectomy, myomectomy and some medications were utilized. And for women that don't want surgery or women that want to preserve their fertility, or they're not surgical candidates, UAE is an incredible option for women. And I think it's something that the intent of this podcast was to highlight the importance and the awareness of that, at least for our listeners.
Again, I'd like to thank Dr. Caridi for a fascinating discussion and her vision and expertise in providing uterine artery embolization to women with uterine fibroids at UAB. As always please rate this podcast and we welcome any comments, particularly on topics that you're all interested in. And for more information on uterine artery embolization and the clinical services that UAB provides, please check out UABmedicine.org. And until next time, thank you very much to our and hope you have a great day.
Dr. Huh (Host): Hello, this is Dr. Warner Huh, the Chair of Obstetrics and Gynecology at the University of Alabama, Birmingham. And I'd like to welcome to this monthly episode of Women's Health with Dr. Huh. Today, we're going to be discussing a truly practical important topic, and there perhaps isn't more cutting edge in women's health and the topic of uterine artery embolization. And with us today is Dr. Theresa Caridi, who is the Director and Associate Professor in the Division of Vascular and Interventional Radiology, and also serves as Vice-Chair of Interventional Affairs in the Department of Radiology. Some of our listeners may be already familiar with this topic, but the reason we're discussing this today is really, it's importance in terms of the modern management of uterine fibroids and symptoms related to that. So Dr. Caridi is a true expert in this area. She has performed thousands of these procedures and we were lucky to recruit her from Georgetown University and welcome Dr. Caridi.
Theresa Caridi, MD (Guest): Thank you, Dr. Huh. It's a real pleasure to be here. I'm so grateful for the opportunity to speak with you today.
Host: So, I know that you have, I have significant familiarity with uterine fibroids and, you know, obviously it's a highly common problem, but I thought maybe you might want to comment for our listeners on just the general incidence and prevalence and symptoms and treatment options related to fibroids.
Dr. Caridi: Absolutely. Uterine fibroids are extremely common in the female population. In fact, about 70% of Caucasian women and 80% of black women have uterine fibroids by the age of 50. Now, not all of those women experience symptoms related to their fibroids. So, about half of those women have symptomatic uterine fibroids. So, some of those symptoms include heavy menstrual bleeding or long cycles. They can also have bulk symptoms. So, bloating or urgency to go to the bathroom frequently or even constipation. They can have pelvic pain and there are several treatment options for these symptoms. One is to do nothing, of course, it's a benign condition, so they don't have to be treated. But there are various treatment options and therapies, depending on a woman's preferences. Some of those include medications to mitigate the symptoms. You can have a definitive treatment with hysterectomy, which removes the uterus of course, more in your territory.
You can have individual removal of fibroids via myomectomy if you're the appropriate candidate, or you can undergo something like uterine fibroid embolization, or uterine artery embolization for fibroids, which is a minimally invasive procedure that doesn't require a surgery but treats the fibroids globally all at the same time in a similar sense to a hysterectomy although it leaves the uterus behind.
Host: Yeah. So what I'm hearing is that really uterine artery embolization is really the ultimate form of minimally invasive treatment for fibroids. And it's interesting because for years, you know, the only treatments that we had were birth control pills or myomectomy, or even hysterectomy. And it's interesting how UAE or uterine artery embolization has become sort of a mainstay of therapy over the last several years. Could you describe to the listener what exactly is uterine artery embolization? Some of our listeners may not be familiar with the actual technique.
Dr. Caridi: Absolutely. Uterine artery embolization, and sometimes you'll hear it referred to as uterine fibroid embolization specifically when it's for the treatment of fibroids. But this procedure is essentially a way that we go in and block the blood supply to the fibroids. And when you starve the fibroids of their nutrients and oxygen by blocking their blood supply, that makes the fibroids essentially die for lack of a better word.
And so they can no longer cause the symptoms that they were previously causing. We don't remove anything. The incision for this procedure is a few millimeters and in fact just essentially needs a glorified band-aid on top of it before discharge that day. We use in order to treat the fibroids and block their blood supply, we use a tiny catheter that goes inside the vessel, either in the upper leg or in the wrist. It's very similar if you've heard about heart catheterizations, when you think about, the little catheter that is used for that, it's on a few millimeter scale. That's very similar to what we do with uterine fibroid embolization.
Host: So, can you comment on a little bit like who are candidates for this kind of procedure? You know, who would, you know, if they were to come to you and you're like, oh, you'd be a great candidate for this. I mean, who are those people?
Dr. Caridi: Ideally, women with fibroids should get a consultation with both a gynecologist and an interventional radiologist, because in reality, all women are potential candidates for any therapy and really need to talk to an expert about the nuances of the ideal treatment for them. There are some patients who wouldn't be ideal for a uterine artery embolization, and those include women who are either of course, actively pregnant or have an active infection.
And then there's the gray zones. Those women who might want future fertility, they kind of fall into a gray zone and we can talk a little bit more detail about that. One of the other areas that I consider a bit of a gray zone is very dependent on the fibroid location. And so it's not that a woman cannot undergo uterine artery embolization if their fibroid is for instance, in a location within the endometrial canal, which is where baby is grown during pregnancy.
If a woman has a fibroid in that location, there is some increased risks to doing a uterine artery embolization that need to be discussed in consultation. And it may not be the optimal choice for that patient. But every patient is unique and every fibroid is unique. And so that discussion really needs to happen in a consultation.
There's also fibroids on the outside of the uterus and those are called subserosa fibroids. We can also treat those via uterine artery embolization. However, if a woman is seeking a certain outcome, for instance, if she comes and says, I would like a cosmetic result of my abdomen or pelvis to not feel this enlarged, I have to counsel that patient, that we may not achieve the degree of volume reduction of that fibroid that they may want. So, those are the gray zones that we need to have further conversation about it in clinic.
Host: You were getting into the issue of risks. So what are the actual known risks of an embolization procedure like this one?
Dr. Caridi: One of the more common things that happens with any embolization procedure in some patients who undergo embolization is something known as post embolization syndrome. So, women can feel kind of flu like for, even up to a week after embolization. And that's from all the inflammation that is caused by taking away that blood supply to the fibroids.
Other things that can happen after embolization, and probably one of the larger things that make women consider this versus other options is uterine artery embolization can be painful and it's kind of an accelerated recovery. So, it's not a lengthy recovery, like might be for an open surgery.
However, you get a lot of inflammation and pain that first evening after the procedure in most patients. And so it's a bit of an accelerated recovery, by the next day, things are much, much better. And usually women only need a few days to recover from a uterine artery embolization. Now, when I discuss this in clinic with a patient, I usually recommend that they take a week off work and plan for a week because in the extreme circumstances, there are women who need a full week to recover.
Host: So, I'm going to take you up on your comment in this gray zone or future fertility. So, I am sure that we have a lot of listeners who have symptoms related to fibroids, whether it's pain, bleeding, et cetera, but they're very much interested in preserving their future fertility. I wonder if you can comment on that?
Dr. Caridi: Absolutely. As you can imagine, this is a very difficult area to study. Women who are candidates for fibroid embolization or other fibroid treatments are usually not in the ideal years for fertility as it is. So, they may have other reasons to have fertility challenges, often they're in their forties and not in the optimal years for conceiving.
So, when you look at these A studies, that have allowed patients who want to conceive to undergo either uterine artery embolization or another fibroid treatment. It's very challenging to look at those rates and know whether it's the procedure that impacted their ability to get pregnant, or the fact that they were not at their optimal fertility years to begin with.
However, one of the other challenges with it is do we compare uterine artery embolization to the gold standard, which is hysterectomy. We can't do that if we're talking about fertility or do we compare it to myomectomy, which is another somewhat minimally invasive way to treat fibroids. And that's typically what's done of course, because that preserves a uterus similar to uterine fibroid embolization.
I think in reality, if you look at the data, the most recent data is from the Femme Trial, which was published last year. And that shows that the pregnancy rates were very similar and delivery rates were very similar. In fact, no difference. But again, the studies are very difficult to do. And I think if someone were to ask me if I would suggest this procedure to a family member or myself or any woman who is desiring future pregnancy, I would say let's explore your other options first.
I think there's some impact probably on fertility when you do global embolization of the uterus. Similarly, I think there are some impact when you do myomectomy of the uterus and make incisions on the uterus to remove the fibroids. So, it's not ideal, but there are certain circumstances where a woman doesn't have any other options and her quality of life is so poor from her fibroids that she may opt to undergo either a uterine fibroid embolization or a myomectomy with the right counseling.
Host: Yeah. I mean, I'll take that one step further. You know, as a surgeon who obviously operated on thousands of women with really significant fibroids, it's remarkable to me how this procedure in and of itself has improved the quality of life of women, and we have a lot of women who are not surgical candidates for whatever reason, and this is their last resort and it's remarkable how much it's turned their life around. It's it's impressive.
Dr. Caridi: I agree. Obviously I'm a little biased, but it's something that I've been really passionate about for several years. And in fact, where I trained at Penn, I thought it was going to be segueing more into the interventional oncology space, but I was exposed to the treatment of uterine fibroids from some of my mentors and I was so moved by seeing these women back in clinic and the experience they had and the significant degree of symptom reduction without having a surgery. And so it was really that experience that led me to get so passionate about it and really focus a lot of my career towards women's health within the interventional radiology space.
Host: So can you comment, for the listeners, what's the expected recovery after an embolization procedure? What can an individual expect?
Dr. Caridi: The expected recovery is, as I mentioned before, it's very accelerated in that first evening. It can be a challenging night to be honest with you. And most of the time, by the time of discharge later that day, a woman is doing well enough to care for herself. However, on occasion, we do keep a woman one night in the hospital, just depending on their level of pain control. Usually a woman recovers in what I consider a long weekend. However, some women require up to a week. That's a bit unusual, but it can happen. And so I tend to tell women to plan for a week of recovery, take that week off work and that way, if they need that full week, they have it. But in general, I would say most women recover in sort of a long weekend type timeframe.
Host: Why should women consider coming to UAB for this type of treatment? Is there something that's unique about the program that we have here that makes UAB best suitable to provide this kind of care?
Dr. Caridi: One of the things I like about the care at UAB in the gynecologic space, is that we can offer all of the possibilities to a woman for her care. And it may be such that she already has a relationship with a gynecologist elsewhere. And that's okay. There's no harm in getting a second opinion or hearing other options beyond maybe a hysterectomy. Here at UAB, we're really able to give the full spectrum of care and we're sub-specialized in such a way that for instance, even though I'm within interventional radiology, this is a passion area of mine that I spend a lot of time pursuing the literature, the technique and research related to this subject matter. And those same experts exist here for gynecology, of course, and specific to fibroid treatments. So, I think one of the reasons is that you can get the spectrum of opportunities here for fibroid treatment.
And another, is the way that we can work together. So, we're able to collaborate well. The fact that you have me on this podcast, I think is evidence of that. Some might consider our procedures and what we're able to offer as competing procedures or competitive. But we are really looking out for a woman's best interest and wanting to pursue any possibility that might be the best treatment option for her.
Host: I'm going to make a statement and I'm assuming that you probably agree with it, that in my experience, uterine artery embolization is best utilized in sort of a coordinated care setting and that it's never done well in isolation or siloed off. And I think that the programs that best do this, do coordinate their care with the gynecologists and the surgeons to make sure that we provide these options. That, and a lot of it is just awareness. The neat thing about this is that we see it as a very important treatment option for our patients and it's very front and center. And I'm grateful that we have the ability to provide that service st UAB.
Dr. Caridi: I absolutely agree with you. I feel very fortunate to be here and to be able to work collaboratively with everyone here. That's not something that exists everywhere and it's a real benefit of being at UAB.
Host: So, how does one make a consultation with you and your team? Can you let the listeners know how that process works?
Dr. Caridi: Just like most services at UAB, we have an interventional radiology clinic, so, women can either come via their gynecologist, or they can self-refer. One of the benefits, again, of being here and being able to work collaboratively, is, if a woman comes as a self-referral, we can plug her into someone here, a second opinion here with gynecology, or if they're seeking more advanced care that they're not able to get where they are in their local community, that can be another reason why we may plug them in here. So, there's lots of ways in which they may get to us. It may be from a gynecologist here, from a gynecologist elsewhere. Or potentially just self-referred to hear more about uterine artery embolization to our interventional radiology clinic. We actually have a separate number that goes straight to our clinic coordinator and she's a nurse and she can triage what might be the best way that woman gets to see us.
And usually that'll just be with a clinic visit. Fortunately, one of the positives that came out of COVID is the ability to use Telehealth as well. So, we are still utilizing Telehealth because a lot of what we're going to discuss can happen actually over a video call. We also have some new endeavors that are reaching out into even further areas of Alabama that are considered quite rural.
And we've set up an opportunity at Whitfield Regional Hospital, actually, where a woman can come to Whitfield and utilize their facilities. There's a room that's already set up where they can be broadcast to us in our interventional radiology clinic and talk about this procedure with us and receive that formal consultation without ever having to make the trip up to UAB.
So, this only exists at Whitfield Regional right now, but we're potentially going to be expanding to other rural areas of Alabama. So, there's many opportunities whether in person or via Telehealth.
Host: That's awesome. That's incredible. Any parting thoughts or comments related to the procedure and the care that we provide, Dr. Caridi?
Dr. Caridi: I think instead of making it even specific to uterine artery embolization, I think what's most important is that women should realize that this disease process runs in families and what they may perceive their grandmother had to have an open hysterectomy in order to treat this disease process. You know, I want women to realize there are many options and they can seek those out and hear about them and see if one might be right for them. And we offer all of those at UAB. So, it's a great place to get that consultation and care. And also, the subject in general about uterine fibroids and heavy bleeding is in the past has kind of been a bit of a taboo topic, but honestly there's no reason at this point to really live with that poor quality of life when there are so many options, and we should be able to speak about it.
Host: No, I totally agree. So, in summary, I think for the listeners, uterine fibroids as mentioned earlier is really perhaps the most common benign tumor that we see in women. I mean, there are millions and millions of women that have this, and we particularly see an increased incidence in the Southeast area. But I think more importantly, that the number of treatment options that we have for patients has grown. And we used to live in an era where only hysterectomy, myomectomy and some medications were utilized. And for women that don't want surgery or women that want to preserve their fertility, or they're not surgical candidates, UAE is an incredible option for women. And I think it's something that the intent of this podcast was to highlight the importance and the awareness of that, at least for our listeners.
Again, I'd like to thank Dr. Caridi for a fascinating discussion and her vision and expertise in providing uterine artery embolization to women with uterine fibroids at UAB. As always please rate this podcast and we welcome any comments, particularly on topics that you're all interested in. And for more information on uterine artery embolization and the clinical services that UAB provides, please check out UABmedicine.org. And until next time, thank you very much to our and hope you have a great day.