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Why aren't more African women offered IR for fibroid treatment?In sub-Saharan Africa, women of reproductive age (15 to 49 years old) find themselves at the crossroads of personal dreams and societal contributions, yet face daunting medical choices. Consider a marketing executive in her mid-30s. At the peak of her career, with plans to start a family, she was diagnosed with uterine fibroids. The only known solutions presented to her involved invasive surgeries with long recovery times and a possibility of infertility. But she discovered an alternative: interventional radiology (IR). Less invasive and promising a quicker return to normal life, it provided hope amidst uncertainty. According to Dr Godfrey Chatora, a diagnostic radiologist at Mic Radiology Group in Zimbabwe, who spoke at the recent WHX Cape Town, these radiology applications can revolutionise treatment options for women, allowing them to resume their lives sooner. ![]() Image credit: Sora Shimazaki on Pexels Uterine fibroids affect up to 70% of women of reproductive age. One in three adult females will be symptomatic, causing significant morbidity: abnormal bleeding, bloating. A significant health burden during active years of life, and in sub-Saharan Africa, they’re 3.25 times more likely in Black women. Uterine fibroid embolisation“I struggle with a significant number of females who have symptomatic fibroids who struggle on with their symptoms because it's a condition where the awareness is so low, but treatment options are available,” says Chatora. One of these treatment options is uterine fibroid embolisation (UFE). The procedure involves imaging techniques like fluoroscopy or MRI to guide the placement of a catheter, usually inserted through a small incision in the groin. Local anaesthesia is used to ensure patient comfort during the procedure. By blocking the blood supply to the fibroids using these beads, UFE causes the fibroids to shrink and alleviate symptoms over time. When comparing intrathecalisation procedures like UFE to surgeries like myomectomy and hysterectomy, UFE offers similar results with a shorter downtime, faster recovery, and return to work. “When we look at (time) and cost efficiencies and what is convenient for the patients, the fibroid embolisation technique holds up very well,” says Chatora. When it comes to fertility, women aren’t able to get pregnant after a hysterectomy. Myomectomy, on the other hand, can improve fertility as it removes the fibroids that interfere with conception and pregnancy. Chatora says that evidence cannot be found in randomised, controlled trials, but anecdotal evidence and case studies indicate that women who struggle to conceive because of fibroids do go on to conceive after embolisation. However, he adds, these pregnancies do need to be monitored closely, given the higher risk of intrauterine growth restriction. UFE in sub-Saharan AfricaAlthough comprehensive African studies specifically focused on UFE are limited, ongoing research efforts at local universities and medical institutions aim to fill this gap. The establishment of more region-specific data will be crucial to supporting evidence-based practices in the future. “Globally, interventional radiology, without a doubt, is now established as the standard care movement, with widespread availability in Europe and parts of Asia, but in the African context, (while) there is a great deal of good work going on, it is still concentrated in a few major centres (like South Africa),” says Chatora. To expand access to interventional radiology in sub-Saharan Africa, several steps could be taken, including:
In conclusion, Chatora says he hopes to get the ball rolling and open the discussion for wider adaptation of some of these treatment strategies in Africa. About Maroefah SmithAfter studying media and writing at the University of Cape Town, Maroefah dived head-first into publishing. Going on to write more than 50 pieces in digital (Bizcommunity) and print media (Seventeen Magazine). While her primary interests are beauty and fashion, she is incredibly adaptable and can take on any topic - from AI to zoology. View my profile and articles... |