WHAT IS UTERINE ARTERY EMBOLISATION?
Uterine Fibroids are benign (non-cancerous) growths in the uterus which may lead to various symptoms including heavy and painful periods, going to the toilet frequently, pelvic pressure, or infertility. Uterine artery embolisation, also known as uterine fibroid embolisation, is a procedure that involves blocking the blood vessels to the fibroid which causes the fibroid to shrink and reduces any symptoms it may be causing. This avoids having to have your uterus removed. The procedure is performed by an interventional radiologist, rather than a surgeon and is an alternative to having surgery.
ABOUT
DIAGNOSIS
PROCEDURE
RECOVERY
RISKS
BENEFITSWHY WOULD MY DOCTOR REFER ME TO HAVE THIS PROCEDURE?
Fibroids are common and most do not require treatment. However, if your fibroids are large or your symptoms are not improving with less invasive treatments, your GP will discuss more invasive treatment options with you. If surgery is an option, you gynaecologist will discuss whether you are suitable. In most women, UAE is also an option and this will be discussed with you by an interventional radiologist. UAE is non-surgical and does not remove the fibroids. Rather, the treatment causes them to shrink.
Wondering If You Qualify for UTERINE ARTERY EMBOLISATION (UAE)?
How do I prepare for the procedure?
Preparation for your procedure will vary between different practitioners and hospitals. You will usually be asked to fast before the procedure (go without food or liquid). You may also need blood tests to check if you have any kidney or blood related problems.
UAE is performed from inside the blood vessels and it does not matter if you are having your period or where you are in your menstrual cycle. If you have an intra-uterine device in place, please speak to your interventional radiologist as to whether this needs to be removed or can stay in place.
What happens during the procedure
The procedure is performed under a twilight sedation. This means you are awake and breathing on your own, but will be made to feel relaxed and comfortable. The procedure uses a combination of ultrasound and x-rays to guide the equipment. The interventional radiologist will pass a catheter (thin, soft plastic tube) into your blood vessel through a small incision in the wrist or groin. Then they guide the catheter through your blood vessels to the specific artery supplying blood to the fibroid. Once the catheter is in the proper position, the doctor releases some medication at the targeted location to block the small vessels and deprive the fibroid of oxygen, which shrinks the fibroid. If necessary, the catheter can be positioned in other arteries that feed the uterine fibroid and repeat the process. When embolisation is completed, the catheter is removed. The small hole made in the blood vessel is closed either using a dissolvable stitch or by putting pressure on the area for a few minutes.
What is the recovery
normally like?
After undergoing UAE, most women experience some pain or
nausea, referred to as “post embolisation syndrome”. This feels
like a normal period but sometimes the pain is a little more intense,
lasting for a few hours. It is not a sign that something has gone wrong and is completely normal. You may be admitted overnight in the hospital to manage your pain and will only be sent home once you pain has reduced. Typically, you’ll be sent home with oral pain medication to use for a few days if you need it. Most women are back to their normal activity in about one week. You’ll have followup appointments with the interventional radiologist a few weeks later.
What are the risks?
Complications after UAE are less likely to occur than after surgery, however all procedures have small risks that can sometime occur even if you have been treated with the best care.
Some of the specific risks associated with UAE are listed below:
- Bleeding or infection at the incision site
- Adverse reaction to the imaging agents (contrast) used during the treatment.
- Infection in the uterus in less than 1% of women. If this occurs, you may need have antibiotics or be admitted to hospital to investigate further.
- Having a heavy period after the procedure, or passing some clots.
- Fever, nausea, or general fatigue that can occur for a few days after the procedure.
What are the benefits?
UAE avoids surgery, preserves your uterus, controls symptoms, and improves your quality of life. Approximately 90% of women who undergo uterine fibroid embolisation will experience significant improvement in their symptoms, or they go away completely.
HOW LONG DOES IT TAKE TO RESPOND TO THE PROCEDURE?
Time for symptoms to improve does vary between women and depends on the size and location of the fibroids as well as the type of symptoms. In some cases, you can see the results within 1 or 2 periods. Other women take a few months to improve. The fibroids will continue to slowly shrink for 2 years.
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