Overview

Uterine fibroid embolization (UFE) is a non-surgical alternative to traditional uterine fibroids removal. The procedure is also referred to as uterine artery embolization (UAE). This procedure is performed exclusively by interventional radiologists.

Uterine fibroid embolization causes fibroids to shrink by cutting off their blood supply. By injecting tiny particles into the arteries that supply the fibroids, the blood supply is cut off. The particles adhere to the vessel wall, causing a clot formation and cutting off the blood supply. When the blood supply to the fibroids is cut off, the fibroids will shrink and the symptoms usually fade or disappear.

Uterine fibroid embolization is a minimally-invasive technique which involves identifying the arteries supplying blood to the fibroids and then blocking off those arteries.

Uterine fibroids are the most common type of abnormal growth in the uterus. Although fibroids are benign, or non-cancerous, their symptoms and side effects can include:

  • Heavy, prolonged menstrual bleeding , sometimes with clots
  • Anemia, a low red blood cell count causing fatigue
  • Pelvic pain, pressure or heaviness
  • Bladder pressure leading to a frequent and hurried urination
  • Back and leg pain
  • Pain during sexual intercourse
  • Constipation and bloating
  • Infertility caused by distortion of the uterine lining
  • Abnormally enlarged lower abdomen

Procedure

Before the procedure

  • Your doctor will explain you the procedure.
  • You will be asked to sign consent form authorizing the procedure.
  • A physical exam may be required prior to the procedure to ensure you are in good health. Blood tests and other tests may also be required.
  • Inform the doctor if you are pregnant or think you may be pregnant.
  • Tell the doctor if you are allergic to contrast dye or iodine.
  • Tell your doctor if you are sensitive to or are allergic to any medicines or local and general anesthesia.
  • Notify your doctor about all medications including prescription, over-the-counter medications and herbal supplements that you are taking.
  • Notify your doctor if you are have any history of bleeding disorders or taking any blood thinning medications or anticoagulant such as aspirin, or other medications that affect blood clotting. You may need to stop these medications prior to the procedure.
  • You may not eat or drink 8 hours from the day before the procedure.
  • You will be given medication to help you relax and a local anesthesia at the groin area.
  • You should take the help of someone to assist you around the house for a day or two after the procedure.

During the procedure

You may be able to have uterine fibroid embolization as an outpatient procedure, or you may need to stay in the hospital overnight. Depending on your condition, the procedure may be performed.

Generally, a uterine artery embolization follows this process:

  • You will be asked to remove jewellery that may interfere in the way of the procedure.
  • You are given a gown to wear and asked to lie down on your back on the procedure table.
  • An intravenous(IV) line will be inserted in your arm or hand.
  • The doctor will insert a long, thin tube (catheter) into your bladder to drain urine.
  • During the procedure,anesthesiologists will monitor your heart rate,breathing, blood pressure, and blood oxygen level.
  • The doctor will use an antiseptic solution to clean the groin area.
  • A small tube (sheath) will be inserted into your groin by the doctor. This will be used as a guiding path to insert the catheter into the arteries that will be blocked (embolized).
  • The contrast dye will be injected directly into the catheter by the doctor. The contrast dye will assist the doctor in locating the artery to be blocked. X-rays will be used to help the doctor locate the blood vessels that supply blood to each fibroid.
  • A tiny catheter will be inserted into the groin (femoral artery) and moved into the arteries that need to be blocked. They will inject tiny particles into the blood vessels.
  • More X-ray images will be taken by the doctor to ensure that the uterine arteries are blocked.
  • If necessary, some doctors will use incision in a single groin site to treat both the left and right uterine arteries. Other doctors may employ two sites of the groin area.
  • After the embolization, the sheath and catheter will be removed.

After the procedure

  • Following the procedure, pressure is applied to the insertion site in the groin to stop the bleeding. This usually takes approximately 20 minutes.
  • After that, you'll be taken to the recovery room. Your blood pressure, heart rate, and breathing will be monitored. You'll have to lie down for a few hours.
  • The type of medication used to help you relax will influence the time of your recovery process. When your vital signs stabilize and you are awake, you will be transferred to your hospital room or sent home.
  • After the procedure, you may experience abdominal cramps. You may be given pain medication by a device connected to your IV line.
  • For a few days, you may have small to moderate amounts of fluid discharged from your vagina.
  • After you have enough rest and your groin puncture site has sealed, you will be encouraged to get out of bed. You should also do deep breathing exercises as directed by your doctor.
  • You may be given liquids to drink a few hours after the procedure. As you gain the ability to eat solid foods, your diet may be gradually modified to include them.

Benefits

After uterine artery embolization, 85-90% of women report significant or complete relief from heavy bleeding, pain, and symptoms associated with uterine enlargement. The procedure is particularly useful for multiple fibroids and large fibroids.

Fibroid embolization also:

  • Provides an effective, minimally invasive alternative to surgery.
  • Presents an alternative to hormone therapy, a type of fibroid treatment.
  • Shorter hospital stay.
  • Allows quick return to normal activities.
  • Preserves the uterus, cervix and ovaries.
  • Significantly improves your quality of life.

Risks

The procedure is safe when performed by an highly experienced interventional radiologist. Some of the risks and complications that may occur include:

  • Post-embolization syndrome consisting of pain, low grade fever, nausea and malaise.
  • Premature amenorrhea: Some women report that they no longer have menstrual periods following uterine fibroid embolization. This is rare in women under the age of 35.
  • Infection of the uterus or the area of the puncture site in the groin.
  • Hemorrhage (abnormal bleeding).
  • Injury to the uterus.
  • Hematoma (large accumulation of blood such as with a bruise) at the puncture site in the groin.
  • Injury to the artery being manipulated.
  • Blood clots.
  • Infertility.

Care at Medicover

Medicover Hospital has an expert team of interventional radiologists who collaborate with gynecologists to offer the latest treatment options and provide personalized care for our patients. By getting to know and listening to our patients, we understand their needs, as well as their most difficult symptoms. Our medical team has had a great deal of success in treating patients with uterine artery embolization. Each patient is carefully evaluated by our specialists to see if they are a good candidate for uterine fibroid embolization treatment. Our team of interventional radiologists work with other specialists in reproductive health and nutrition to help patients receive high-quality, personalized care.


Citations

https://myhealth.ucsd.edu/Library/TestsProcedures/92,P08484
https://www.pennmedicine.org/for-patients-and-visitors/find-a-program-or-service/interventional-radiology/uterine-fibroid-embolization
https://www.ucsfhealth.org/treatments/uterine-artery-embolization
https://www.acog.org/womens-health/faqs/uterine-artery-embolization
https://healthcare.utah.edu/radiology/preparing-appointment/interventional-radiology/after-uterine-fibroid-embolization.php
https://www.cedars-sinai.org/programs/imaging-center/exams/interventional-radiology/uterine-fibroid-embolization.html
https://www.columbiaradiology.org/patients/services/interventional-radiology/uterine-fibroid-embolization
https://www.beaumont.org/treatments/uterine-fibroid-embolization

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Frequently Asked Questions

1.What is uterine artery embolization(UAE)?

Uterine artery embolization is a procedure that involves injecting tiny particles into the blood vessels that lead to the uterus. The particles block blood flow to the fibroid, causing it to shrink.

2.Why is the uterine artery embolization done?

UAE can help women who have fibroids and want to keep their uterus. They may have tried medication first but were not relieved. UAE is also used to treat women who are bleeding profusely after giving birth.

3.What are the benefits of uterine artery embolization?

UAE may reduce pain, pressure and bleeding from the fibroids. It is less painful than a hysterectomy. UAE can treat many fibroids at the same time, and it is not affected by abdominal scar tissue from prior surgery. UAE typically involves shorter hospital stay, allows you to get back to work early and has lower rates of blood transfusion.

4.Who performs uterine fibroid embolization?

The procedure of uterine fibroid embolization is done by an interventional radiologist who treats the fibroid without any major surgery.

5.How fast do uterine fibroids shrink after embolization?

Each person is different, but it usually takes 2-3 months after embolization of uterine fibroids to begin shrinking. When this happens, symptoms should also start improving as well.