Uterine fibroid embolization
What is uterine Fibroid embolization?
Uterine Artery Embolization is a percutaneous, nonsurgical treatment for uterine leiomyomas (fibroids). Fibroids are non-cancerous tumors which may cause very heavy menstrual cycles, a condition called abnormal uterine bleeding. Alternatively, large fibroids can press on adjacent organs, such as the bladder and cause pelvic pain. During embolization, tiny particles are injected into the artery that supplies blood to the tumor in the uterus until the artery is blocked off (embolized). Once blocked, the fibroid becomes deprived of oxygen and shrinks in size.
How do i prepare and how is it performed?
The night before eat sensibly, something easy to digest. You might not be evacuating your bowels regularly following the procedure due to the use of pain medications, so this is important. Do not eat or drink anything past midnight. You will be instructed when to arrive the morning of the procedure. After registering, you will be sent to the Special Procedures Area (SPA), were you will have an intravenous (IV) line placed in your arm, and a tube will be placed into your bladder. Fluids, antibiotics and anti-nausea medications will be given prior to your procedure. You will then be sent to the Interventional Angiography Suite. Here you will meet doctors (Interventional Radiologist) and nurses/technologist trained in this procedure. You will be given sedation for relaxation and pain, but you will be conscious during the procedure.
The Radiologist will place a small catheter (a small tube) into an artery in your groin and will perform an angiogram which will specifically look at the arteries in your pelvis which supply blood to the uterus. After these arteries are identified, the catheter is directed into the branch of the artery supplying blood to the fibroids. Embolization particles are injected until the artery is blocked. Both uterine arteries will be treated in this manner. Once completed, the catheter is removed.
Most women have moderate cramping for one to three days after the procedure. Total recovery time is approximately one week.
How does Embolization work?
The uterus is unique in having multiple blood supplies. When a fibroid grows in the uterus it receives almost all its blood supply from the uterine arteries. Therefore, blocking agents injected into the uterine artery reach the tumor and cut off blood-flow to the fibroid while other blood vessels continue to supply blood to the remaining healthy uterine tissues. With the blood supply blocked, the fibroid will shrink.
Almost all of our patients have some bruising around the site of entry into your artery. This will appear dark brown and yellow just like any other bruise. Following embolization and discharge from the hospital, most patients experience some pelvic pain and cramping. We will give you medicine (Percocet and Toradol/Motrin) to help with these symptoms. Other patients have occasionally complained of nausea. We will give you medicine to take rectally (Phenergen), if necessary. Some of our patients have experienced a low-grade fever. We ask that you take your temperature once a day, even if you don’t feel like you have a fever, and call us if it goes over 101 F. It is not abnormal to have some spotting in the first week/month after an embolization.
Serious complications for embolization are rare. In less that 1% of the procedures the fibroids or parts of the uterus may become infected or abscessed. In rare cases a hysterectomy may have to be performed.
Will embolization help me?
Approximately 80% of patients will see a reduction in abnormal uterine bleeding and pelvic pain. Early figures here in the USA and in Europe suggest the fibroids do not recur after embolization.
For additional information or to schedule a uterine fibroid embolization consultation please contact our clinical coordinator at 505-559-5653.