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Uterine artery embolization (UAE) is a procedure that offers an alternative to traditional surgical removal of uterine fibroids. The procedure may also be referred to as uterine fibroid embolization (UFE).
Uterine artery embolization shrinks fibroids by blocking off their blood supply. The blood supply is blocked by injecting very small particles into the arteries that supply the fibroids. The particles stick to the vessel wall and cause a clot to develop, blocking off the blood supply. Once the blood supply is gone, the fibroids shrink and symptoms usually decrease or disappear. The most commonly used particle agent is polyvinyl alcohol (PVA), a substance that has safely been used in medical procedures for many years.
Uterine artery embolization is a minimally-invasive (without a large abdominal incision) technique which involves identifying which arteries supply blood to the fibroids and then blocking off those arteries.
Uterine artery embolization is performed by an interventional radiologist, a physician specializing in the field of radiology that treats a wide range of internal body conditions without making a surgical incision. Various small instruments or tools, such as catheters or wires, are used, along with various x-ray and imaging techniques (e.g., computed tomography (CT scan), magnetic resonance imaging (MRI), fluoroscopy, and ultrasound). Interventional radiology offers an alternative to the surgical treatment of many conditions and can eliminate the need for hospitalization, in some cases.
The organs and structures of the female pelvis are:
Other related procedures that may be performed to diagnose or treat problems of the uterus include cervical biopsy, colposcopy, dilation and curettage (D and C), endometrial ablation, endometrial biopsy, hysterectomy, hysteroscopy, laparoscopy, loop electrosurgical excision procedure (LEEP), and pelvic ultrasound. Please see these procedures for additional information.
The primary reasons for performing a uterine artery embolization include:
Other reasons for performing a uterine artery embolization include, but are not limited to, the following:
There may be other reasons for your physician to recommend a uterine artery embolization.
As with any procedure, complications may occur. Some possible complications include, but are not limited to, the following:
Some women experience postembolization syndrome. Symptoms of this condition may include, but are not limited to, the following:
Symptoms of postembolization syndrome last approximately 2 to 7 days. Pain medications and anti-inflammatory medications may be prescribed, as well as agents to help with nausea.
The first clinical study of uterine artery embolization for the treatment of uterine fibroids was published in 1995. Since then, studies assessing both short and long-term effectiveness and outcomes have found UAE to be a safe and effective option for many women. Compared with surgical methods such as hysterectomy or myomectomy, most women had less post-surgery pain, and had a quicker recovery after a UAE procedure. However, some long-term studies found women undergoing UAE were more likely to need another future treatment or surgery, compared to women who had surgical procedures such as hysterectomy for treating uterine fibroids.
Some women, especially those older than 45 to 50 years of age, will go into menopause after UAE.
One advantage of UAE over some surgical treatments for fibroids is that the uterus is not removed, leaving the option for a future pregnancy. However, more studies are needed to determine the effects of this procedure on future fertility and pregnancy.
There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.
Uterine artery embolization may be performed as an outpatient procedure or may require an overnight stay in a hospital. Procedures may vary depending on your condition and your physician's practices.
Generally, a uterine artery embolization follows this process:
Continuous pressure will be applied to the catheter insertion site in the groin for as long as needed to control the bleeding from the puncture site, generally about 20 minutes.
You will then be taken to the recovery room for observation. You will be instructed to lie flat for four to six hours. Your recovery process will vary depending upon the type of sedation that is given. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged home if appropriate.
Abdominal cramping may occur after the procedure. You may receive pain medication as needed, either by a nurse or by administering it yourself through a device connected to your intravenous line.
You may have small to moderate amounts of vaginal drainage for several days. The nurse will check the sanitary pads periodically to monitor the amount of drainage.
You will be encouraged to get out of bed within a few hours. In addition, you should perform coughing and deep breathing exercises as instructed by your nurse.
Depending on your situation, you may be given liquids to drink a few hours after the procedure. Your diet may be gradually advanced to more solid foods as tolerated.
Arrangements will be made for a follow-up visit with your physician, usually one to two weeks after the procedure. At that time an ultrasound or MRI may be scheduled within six months of the procedure to determine its effectiveness.
Once you are home, it is important to keep the groin incision clean and dry. Your physician will give you specific bathing instructions. If adhesive strips are used, they should be kept dry and generally will fall off within a few days.
The incision, abdominal, and pelvic muscles may ache, especially after long periods of standing. Take a pain reliever for soreness as recommended by your physician. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
Walking and limited movement are generally encouraged, but strenuous activity should be avoided. Your physician will instruct you about when you can return to work and resume normal activities.
Avoid becoming constipated by including fiber and plenty of liquids in your diet, as straining to have a bowel movement may cause problems. Your physician may recommend a mild laxative.
You should not use a douche, tampons, engage in sexual intercourse, or return to work until your physician advises you to do so.
Notify your physician to report any of the following:
Following a uterine artery embolization, your physician may give you additional or alternate instructions, depending on your particular situation.
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.
This page contains links to other Web sites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we do not control or endorse the information presented on these Web sites, nor do these sites endorse the information contained here.