Uterine Artery Embolisation

Uterine artery embolisation treats the fibroids by reducing the flow to  the arteries that supply them. A catheter is introduced into the femoral artery in the groin or more recently through the radial artery in the left wrist   and is directed, using x-ray guidance to the arteries supplying the uterus. Once in the right place, an embolic agent is injected. The agent is made of bio absorbable  particles that  occlude the blood flow to the fibroid, causing the uterine fibroids (and the uterus) to shrink in size.

Important to note with a uterine artery embolisation;

  • Majority of patients can return to work within 2 weeks
  • Early menopause less than 4% in women under 45 and unto 20%  over that age

 

Uterine Artery Embolisation Q and A;

Q. Can the particles used in uterine artery embolisation leak or cause any damage to other parts of the body?

A. Bio absorbable particles are injected into the artery supplying the fibroids. Non-target embolisation, a condition when some particles inadvertently flow into other parts of the body, may occur in extremely rare cases.

Q. How fast does uterine artery embolisation work?

A. Fibroids begin to shrink immediately. Improvement in bleeding is immediate, and shrinkage is reached 90% of total by six months after the procedure. Heavy bleeding from fibroids reduces significantly from the next menstrual period.

Q. Are there side effects from the Uterine Artery Embolisation?

A. Most patients experience cramping pain for one or two days after embolisation. Patients go home on the  next day. Some patients, especially those with larger fibroids experience a low-grade fever for a few days after embolisation.This is referred to as post embolisation syndrome.

Q. Is general anesthetic administered?

A. For embolisation, no. This procedure is done under local anaesthetic and sedation in most instances. General anaesthetic is rarely used. A nerve block (hypogastric nerve) may also be performed before, during or after the procedure.

Q. Will uterine artery embolisation keep new fibroids from forming?

A. Recurrence after embolisation may occur. This can also happen after myomectomy. Uterine artery embolisation can be repeated if required and does not prevent or preclude further surgery including myomectomy or hysterectomy from being performed in the future.

Q. What are some of the reasons I wouldn’t be a candidate for uterine artery embolisation?

A. Embolisation is not a cure for cancer. Certain other diseases might be present causing symptoms similar to those caused by fibroids. We will screen you for these conditions.  Allergy to iodinated contrast (dye given during the procedure) and pregnancy are contra indications.

Q. Is embolisation experimental?

A. Embolisation has been used to control hemorrhage (heavy bleeding) in many parts of the body, including the uterus for more than twenty years. Nothing is experimental about the procedure. Embolisation has been approved by Medicare, and is covered by all private health insurance plans. The procedure has been endorsed by the National Institute of Clinical Excellence (NICE) and the other major Interventional Radiology societies around the world including CIRSE(Cardiovascular and Interventional Radiology society of Europe) and SIR(Society of Interventional Radiology of North America)

Q. What about fertility?

A. Women have conceived after embolisation. Women have successfully carried babies to term after embolisation. Early menopause less than 4% in women under 45 and unto 20%  over that age. Ask your doctor about the risks to fertility associated with major surgery such as myomectomy.

 

Q. I have several fibroids, one that is said to be pedunculated, outside of my uterus. Can these type of fibroids be treated with Uterine Artery Embolisation?

A. Yes. Many types of fibroids can be treated with UAE, because the procedure involves blocking the blood supply to the fibroid. Certain narrow necked pedunculate fibroids with long stalks may be easier to access  with laparoscopic surgery.

Links:

The Society of Interventional Radiology recently released a campaign #fibroidfix to educate women around the world of the non-surgical, minimally invasive treatments available for fibroids. A hysterectomy may not be your only answer.

You can read more on this campaign below;

UFE – Patient Info Sheet

https://www.sirweb.org/patients/fibroid_fix2/ufe-resources/

UFE – Procedure Checklist

https://www.sirweb.org/patients/fibroid_fix2/ufe-checklist/

http://www.sirweb.org/patients/uterine-fibroids/