Uterine Artery Embolization

When very common non-cancerous growths called uterine fibroids develop in the muscle wall of the uterus, they can occur with and without symptoms.  The fibroids are usually diagnosed during an internal gynecologic exam and confirmed using either ultrasound or an MRI exam.  About one third of the women who have fibroids develop significant symptoms such as heavy menstrual bleeding, bleeding between periods, painful intercourse, pelvic pain and frequent urination.

What is Uterine Artery Embolization?

Uterine artery embolization, is a minimally-invasive surgical procedure performed by an interventional radiologist to treat conditions involving the presence of uterine fibroid tumors by blocking their blood supply and shrinking them.  

Is Uterine Artery Embolization right for me?

Uterine artery embolization, unlike a complete or partial hysterectomy, does not remove any of a woman’s reproductive organs.  An MRI exam helps in selecting patients who should receive non-surgical uterine fibroid embolization. Interventional radiologists interpret the MRI images to determine if a fibroid tumor can be embolized, detect alternate causes for the symptoms, identify conditions that could prevent the procedure and avoid ineffective treatments. Patients should discuss their options with their gynecologist and interventional radiologist.

Is Uterine Fibroid Embolization safe?

While uterine fibroid embolization is safe, like any surgical procedure, there are risks which you should discuss with your physician. It has been performed using FDA approved embolic particles on thousands of patients for over 20 years without long-term complications. A small number of patients have experienced infection, which usually can be controlled with antibiotics. There is also a 1 percent chance of injury to the uterus, potentially leading to hysterectomy.  Less than 2 percent of patients have entered menopause as a result of the procedure.

How should I prepare for this procedure?

The patient should not eat for at least six hours prior to having uterine fibroid embolization.  For the exam, an intravenous catheter is used to administer the medication for conscious sedation.  With the patient lying on her back on a special table that includes a fluoroscopic x-ray machine, the interventional radiologist makes a one-quarter of an inch incision in the groin to access the femoral artery.  This is done with using local anesthesia.  A catheter is then inserted into the artery and guided to the uterus.  The procedure is monitored with the aid of the fluoroscopic x-ray machine to show the progress of the catheter.  When the catheter is properly positioned, the radiologist injects tiny grain-sized plastic particles into the artery cutting off the blood supply to the fibroids causing them to shrink.

What should I expect during this exam?

Uterine fibroid embolization takes about an hour. After the procedure, the patient is required to remain in a hospital setting overnight.  Most women experience moderate to severe pain and cramping for several hours after having the procedure.  On occasion some may also experience fever and nausea. The majority of women are able to return to normal activity 7 to 10 days after the procedure and many resume light activities in a few days.  Between 85 to 90 percent of women experience significant or complete relief of heavy bleeding and relief from pain.

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