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:
- Menorrhagia (with
or without anemia)
- Chronic pelvic,
back, or leg pain or discomfort that can be attributed to the fibroids
- Ureteral compression
causing dilated renal collecting structures or urinary symptoms referable
to compression of the bladder.
Pre-Procedure
Gynecologic Evaluation:
- 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.
- We also need
the results of the most recent Pap smear, which must be within the
last year and should be normal.
- 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.
- 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:
- 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.
- 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.
- 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.
- 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 |
