Explanation of Uterine Artery Embolization
Women with uterine fibroids have several treatment options. They can take nonsteroidal anti-inflammatory drugs (NSAIDs) to obtain relief from the painful symptoms. They can take hormone-based medication, but it unfortunately has unpleasant side effects. Or they can go to the root of the problem (pun intended) and starve the fibroids of blood supply, causing them to shrink. This procedure is called uterine artery embolization (UAE).
Who Needs Uterine Artery Embolization?
Many women have small uterine fibroids they may not be aware of. They can vary in size from a seedling to a large clump. When they grow significantly large, fibroids can cause lots of painful symptoms from prolonged and painful menstruation to frequent urination.
In these cases, uterine artery embolization is a good choice, with a few precautions. This procedure may make getting pregnant more difficult and increase the risk of pregnancy complications. For women over the age of 45, UAE may speed the onset of menopause. Therefore, during the childbearing years, women should consider their options carefully.
Who Performs a Uterine Artery Embolization?
UAEs are performed by doctors called Interventional Radiologists. This specialization uses a combination of minimally invasive surgery, imaging technology (MRI, CAT scans) to perform precise and delicate procedures in difficult to reach areas of the body, such as arteries and veins.
In order to pinpoint the location of the procedure, the Interventional Radiologist uses a contrast material containing iodine, which is injected into the bloodstream.
Preparing for the Procedure
Your doctor will explain to you the risks of the procedure and ask you to sign a consent form. The risks associated with uterine artery embolization are:
- Allergic reaction to iodine-based contrast material
- Infection, if your fibroids are of a degenerative nature
- Bleeding
- Problems with ovarian function.
After you sign the consent form, the doctor will instruct you to refrain from eating and drinking after midnight before the procedure. Also, you must inform the doctor of any medication that you are taking.
How Uterine Artery Embolization Is Performed
You will be taken to a radiology procedure room where you will remove all clothing and jewelry and put on a hospital gown. An intravenous (IV) line will be placed in one of your veins to deliver fluids, antibiotics, anesthetics and pain medication. The type of anesthesia used for UAE is called conscious sedation. It means that you will be relaxed and feel no pain, but you will be awake.
Once you are sedated, the doctor will make a small incision above the femoral artery, which runs down your groin area. A catheter goes into the incision and the doctor guides it towards the uterine arteries. The catheter will be able to reach both uterine arteries from the same incision.
The contrast material is injected to help the doctor map your blood vessels. Once the ideal spot for embolization is spotted, the doctor directs a stream of tiny gelatin particles, fine like sand grains. They will stop at the precise location and cut off the blood flow to the fibroids.
Recovery
In most cases, you will be able to leave hospital after one night of observation. You will have a sterile bandage placed over the incision and receive pain medication. About three months after the uterine artery embolization, you will go for a follow-up examination, which will include a MRI scan.