Uterine Fibroid Embolization
Minimally invasive relief for painful uterine fibroids
If you have uterine fibroids that cause abnormal bleeding, chronic pelvic pain and frequent urination, uterine fibroid embolization may help relieve your symptoms. Uterine fibroid embolization (or uterine artery embolization) is a minimally invasive procedure that cuts off the blood supply to uterine fibroids and causes them to shrink.
Overview
If you have uterine fibroids that cause abnormal bleeding, chronic pelvic pain and frequent urination, uterine fibroid embolization may help relieve your symptoms. Uterine fibroid embolization (or uterine artery embolization) is a minimally invasive procedure that cuts off the blood supply to uterine fibroids and causes them to shrink.
An interventional radiologist will perform your uterine fibroid embolization procedure in a catheterization lab. You will be under local anesthesia, so you won’t feel any pain during the procedure.
When you arrive at the hospital, you will be asked to change into a hospital gown. A nurse will insert an intravenous (IV) line into your hand or arm so that you can receive sedative medicine to help you relax. Then, you will be taken to the catheterization lab. You may or may not remain awake during the procedure, depending on how deeply you are sedated.
A nurse will shave, sterilize and cover with a surgical drape the area of your body where the catheter will be inserted. To reach the fibroids, the interventional radiologist places a catheter into the femoral artery (located in the groin area) or the radial artery in the wrist. You may feel some pressure when the catheter is inserted. X-ray images help the interventional radiologist guide the catheter to the uterus.
Next, a contrast material is injected in order to highlight the uterine arteries on the X-ray images. As the contrast material passes through your body, you may get a warm feeling. Small particles are then injected into the uterine artery that feeds the fibroids. The particles block blood supply to the fibroids, which causes the fibroids to gradually begin to shrink.
At the end of the procedure, the interventional radiologist will remove the catheter and apply pressure to stop any bleeding. He or she will cover the incision with a dressing. No sutures are needed.
What to Expect During Your Uterine Fibroid Embolization
An interventional radiologist will perform your uterine fibroid embolization procedure in a catheterization lab. You will be under local anesthesia, so you won’t feel any pain during the procedure.
When you arrive at the hospital, you will be asked to change into a hospital gown. A nurse will insert an intravenous (IV) line into your hand or arm so that you can receive sedative medicine to help you relax. Then, you will be taken to the catheterization lab. You may or may not remain awake during the procedure, depending on how deeply you are sedated.
A nurse will shave, sterilize and cover with a surgical drape the area of your body where the catheter will be inserted. To reach the fibroids, the interventional radiologist places a catheter into the femoral artery (located in the groin area) or the radial artery in the wrist. You may feel some pressure when the catheter is inserted. X-ray images help the interventional radiologist guide the catheter to the uterus.
Next, a contrast material is injected in order to highlight the uterine arteries on the X-ray images. As the contrast material passes through your body, you may get a warm feeling. Small particles are then injected into the uterine artery that feeds the fibroids. The particles block blood supply to the fibroids, which causes the fibroids to gradually begin to shrink.
At the end of the procedure, the interventional radiologist will remove the catheter and apply pressure to stop any bleeding. He or she will cover the incision with a dressing. No sutures are needed.
You should talk to your doctor if you plan to have children and are considering uterine fibroid embolization. Pregnancy after embolization is possible, but success rates are not known. Most doctors do not recommend the procedure if you still want to have children.
A few days or a few weeks before your procedure, your doctor will gather information about your symptoms and take images of your uterus, using either MRI or ultrasound, to note the location, size and number of fibroids. If you are bleeding heavily between menstrual cycles, your doctor may also take a biopsy of the inner lining of the uterus (endometrium) to rule out cancer.
Follow your doctor's instructions the night before the procedure. Typically, you will be asked not to eat or drink after midnight and to restrict certain medicines, such as aspirin or other blood thinners. You should plan to stay overnight at the hospital on the day of the procedure.
Preparing For a Uterine Fibroid Embolization
You should talk to your doctor if you plan to have children and are considering uterine fibroid embolization. Pregnancy after embolization is possible, but success rates are not known. Most doctors do not recommend the procedure if you still want to have children.
A few days or a few weeks before your procedure, your doctor will gather information about your symptoms and take images of your uterus, using either MRI or ultrasound, to note the location, size and number of fibroids. If you are bleeding heavily between menstrual cycles, your doctor may also take a biopsy of the inner lining of the uterus (endometrium) to rule out cancer.
Follow your doctor's instructions the night before the procedure. Typically, you will be asked not to eat or drink after midnight and to restrict certain medicines, such as aspirin or other blood thinners. You should plan to stay overnight at the hospital on the day of the procedure.
In the hospital
Immediately after uterine fibroid embolization, you may experience intense abdominal cramping and pain. Your care team will help manage your pain with a narcotic pain medicine while you are in the hospital.
The interventional radiologist who performs the embolization will discuss the results of the procedure with you as well as any special instructions to follow after you return home. You should be able to return home the day after the procedure.
Recovery at home
After you return home, you may have mild nausea, a low fever and pelvic cramps for several days. Your doctor will prescribe medicine to help relieve your pain and fever.
Recovering from uterine fibroid embolization takes much less time than recovering from a hysterectomy. Most women feel back to normal within one or two weeks. Within two to three weeks after embolization, you should feel relief from you’re the pelvic pain and pressure and frequent urination caused by fibroids. As the fibroids continue to shrink, your symptoms will continue to disappear.
You may notice a reduction in menstrual bleeding after embolization, especially with the first cycle after your procedure. Over time, menstrual bleeding should stabilize to a level that is much less than before the procedure. It is possible to miss a cycle or two. Some women stop having periods, especially if they were already nearing menopause before the procedure.
Following up after your procedure
You can expect to see your doctor within three weeks after your embolization procedure. The doctor will check to make sure you are recovering and feeling well.
If you have any issues after the procedure, your doctor may schedule an MRI or ultrasound imaging to compare to your original images. Uterine fibroids generally do not reappear after embolization. However, if they do, you may need a hysterectomy.
After Your Procedure
In the hospital
Immediately after uterine fibroid embolization, you may experience intense abdominal cramping and pain. Your care team will help manage your pain with a narcotic pain medicine while you are in the hospital.
The interventional radiologist who performs the embolization will discuss the results of the procedure with you as well as any special instructions to follow after you return home. You should be able to return home the day after the procedure.
Recovery at home
After you return home, you may have mild nausea, a low fever and pelvic cramps for several days. Your doctor will prescribe medicine to help relieve your pain and fever.
Recovering from uterine fibroid embolization takes much less time than recovering from a hysterectomy. Most women feel back to normal within one or two weeks. Within two to three weeks after embolization, you should feel relief from you’re the pelvic pain and pressure and frequent urination caused by fibroids. As the fibroids continue to shrink, your symptoms will continue to disappear.
You may notice a reduction in menstrual bleeding after embolization, especially with the first cycle after your procedure. Over time, menstrual bleeding should stabilize to a level that is much less than before the procedure. It is possible to miss a cycle or two. Some women stop having periods, especially if they were already nearing menopause before the procedure.
Following up after your procedure
You can expect to see your doctor within three weeks after your embolization procedure. The doctor will check to make sure you are recovering and feeling well.
If you have any issues after the procedure, your doctor may schedule an MRI or ultrasound imaging to compare to your original images. Uterine fibroids generally do not reappear after embolization. However, if they do, you may need a hysterectomy.
