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LITERATURE REVIEW |  PHYSICIAN'S GUIDE for PATIENT PROTOCOL

 

Physician's Guide for Patient Protocol
Georgetown UFE Protocol and Patient Referral Information

Candidates include those patients over 18 who have one of the following symptoms:
  1. Menorrhagia (with or without anemia)
  2. Chronic pelvic, back, or leg pain or discomfort that can be attributed to the fibroids
  3. Ureteral compression causing dilated renal collecting structures or urinary symptoms referable to compression of the bladder.

Pre-Procedure Gynecologic Evaluation:

  1. Each patient should have a pelvic examination by her gynecologist within six months of the procedure. We will need a copy of the records for the last two gynecology office visits.
  2. We also need the results of the most recent Pap smear, which must be within the last year and should be normal.
  3. For patients with abnormal uterine bleeding (periods lasting longer than 10 days or periods more frequently than every 21 days) , an endometrial biopsy should be done, preferably within the preceding 3 to 6 months. This is to be certain that endometrial carcinoma or hyperplasia is not present. We usually decide if an endometrial biopsy is needed at the time of the interventonal radiology consultation.
  4. If the patient has a history of pelvic infection, cultures for Gonorrhea and Chlamydia should be obtained.

Patients do not need to be seen by a Georgetown Gynecologist.

Pre-Procedure Radiology Evaluation:

  1. All patients will be required to have a pre-procedure evaluation by the interventional radiology staff at Georgetown. This allows us to obtain a gynecologic and general medical history, a brief physical examination, and to review the imaging findings and to discuss the procedure with the patient.
  2. The patient must not be pregnant and we will confirm this with a pregnancy test if the procedure is done more than 14 days after the beginning of the patient's most recent menstrual cycle.
  3. A blood count and FSH will be obtained on the day of the procedure. If the patient has a history of renal disease or coagulation defect, further laboratory testing may be required.
  4. An MRI of the pelvis must be obtained. We prefer that this be done at Georgetown to ensure uniformity of imaging. We have instituted a reduced charge for this study. If the MRI is done at another site, the study must be done with and without contrast and include length, width, and depth of the uterus and the dimensions of the identifiable dominant fibroids. The study must also be of sufficient quality to allow adequate detail of the fibroids and the lining of the uterus. If these are not done, the study will have to be repeated.

Follow-Up Protocol

After the procedure, follow-up visits occurs at 1 week and at 3 months, which will include completing a follow-up MRI and questionnaire. Patients are instructed to continue all their normal gynecologic care with their referring gynecologist. Each gynecologist will be sent a letter at 3 months to update them on the patient's imaging and symptom status.

For more information

If you would like to refer a patient or would like more information, you may call James B. Spies M.D. of Georgetown Interventional Radiology at Phone: (202) 784-3420 to make an appointment. You may also contact him via email at FIBROIDINFO@gunet.georgetown.edu



UAE HOME | WHAT ARE FIBROIDS? | TREATMENT OPTIONS | UAE PROCEDURE
PATIENT'S GUIDE | FIBROID REGISTRY | FINDING A PHYSICIAN
PHYSICIAN'S RESOURCE | ADENOMYOSIS | MEET OUR STAFF