Uterine Artery Embolization

Uterine Artery Embolization (UAE) is a minimally invasive procedure done under fluoroscopy (a moving x-ray) by an interventional radiologist to treat uterine fibroids. Uterine fibroids are non-cancerous growths that develop in the muscular wall of the uterus. Fibroids are not considered to be pre-cancerous and do not always cause symptoms, but their size and location can lead to pain, a feeling of fullness, and heavy bleeding.

Only when a fibroid causes symptoms is it necessary to treat them. Drug therapy is often the first step in the treatment. This may be in the form of birth control or hormonal therapy, or the use of non-steroidal anti-inflammatory drugs. Fibroids often grow back after this therapy is discontinued. The next step is to try more invasive therapy. The most common treatment options include uterine artery embolization; myomectomy, a surgical procedure for the removal of the fibroid; or hysterectomy, removal of the uterus.

As of 2003, approximately 2,000-3,000 patients have had uterine artery embolization (UAE) procedures worldwide. Initial results suggest that symptoms will be improved in 90 percent of patients with the large majority of patients markedly improved. Most patients experience significant or total relief of heavy bleeding, pain and other symptoms. Although more research is necessary for long-term outcomes, one study has shown no regrowth after six years.

How To Prepare For Your UAE Treatment:
You will be admitted the morning of the procedure to short term care; please plan to stay overnight. Do not have anything to eat or drink after midnight the night before your procedure. In addition, if you do not have a thermometer at home, please buy one to have on hand after your procedure.

During Your UAE Treatment:
An intravenous line will be placed for hydration and medication. The interventional radiologist will then make a tiny nick in the skin in the groin while you are conscious but sedated (drowsy), you should feel no pain. The interventional radiologist will then insert a catheter into the artery and guide it to the uterus while monitoring its progress using fluoroscopy (a moving x-ray). Tiny particles the size of grains of sand are injected into the artery that is supplying blood to the fibroid tumor, cutting off the blood flow and causing the fibroid to shrink.

After Your UAE Treatment:
Fibroid embolization usually requires a hospital stay of one night. Intravenous medications will be prescribed to control symptoms that some patients may experience, such as pain, nausea, or a fever. Pain medication will be given with a pump that allows you to self-administer. Fever sometimes occurs with embolization and is usually treated with Tylenol. Most symptoms substantially improve by the next morning, allowing for you to be discharged. Advil is normally prescribed upon discharge for cramping. Many women resume normal activities within a few days and the majority of women are able to return to normal activities within seven to fourteen days.

Potential Risks:
Uterine artery embolization is very safe, but there are some risks as with most medical procedures. Most women have moderate cramps for the first 6 to 24 hours after the procedure. Some women have nausea and fever. Medication can help control these symptoms. A single dose of antibiotics is administered prior to the procedures. A small number of women have experience infection after the procedure which requires additional antibiotics. It has been reported that about 1 percent of the women have had an injury to the uterus from the procedure, potentially leading to a hysterectomy. A small number of women have entered into menopause after the procedure. When this occurs, it is usually in women in their mid-forties or older who may already be nearing menopause. The risks are less than those following a hysterectomy or myomectomy. Adhesions are not a complication.

A recent study comparing the fertility of women who had uterine artery embolizations with those who had a myomectomy showed similar number of successful pregnancies for both groups. The long-term effect of uterine artery embolization on the ability of a woman to have children has not been fully determined.

For more information about Interventional Radiology or to schedule an appointment, please call 732-776-4879.