Uterine Fibroid Embolization - Everything About It!

Uterine Fibroid Embolization (UFE) is also known as Uterine Artery Embolization (UAE). It is a minimally invasive treatment method for the fibroid tumors or myomas of the uterus. Fibroid tumors are benign in nature, arising from muscular wall of the uterus, and rarely turn cancerous. Generally, they cause pressure on bowel or bladder, heavy menstrual bleeding, and pelvic region pain.

In the UFE, X-ray camera called fluoroscope is used to guide to uterus and fibroids. The delivery of small particles which are injected through a flexible thin catheter blocks the arteries providing blood flow causing fibroids to shrink.

Uses:

The procedure is used to prevent pelvic bleeding caused by malignant gynecological tumors, trauma, or hemorrhage after childbirth.

Preparation:

A thorough evaluation of the patient includes a detailed study of medical history, physical examination, menstrual history, and discussion of fertility goals.

MRI or ultrasound of the uterus is performed to assess size, location, and number of the fibroids. A biopsy of the endometric lining of the uterus might also be performed to rule out the possibility of cancer.

Equipment:

X-ray equipment, catheter, medications, and synthetic materials called embolic agents are used in this procedure.

The Procedure:

1. Positioning the patient on the examining table.

2. Tracking heart rate, pulse, and blood pressure during the procedure.

3. Inserting an intravenous (IV) line into a vein in hand or arm for sedative medication, fluids, antibiotics, and pain medications.

4. The area of body where catheter is to be inserted is sterilized and then covered with a surgical drape.

5. Numbing the area with a local anesthetic.

6. Small incision is made at the site.

7. Using X-ray, a catheter is guided into femoral artery located in groin area.

8. A contrast material provides a roadmap for catheter to maneuver into uterine arteries.

9. Releasing the embolic agent into both left and right uterine arteries by repositioning the catheter.

10. At the end of the procedure, the catheter is removed and pressure is applied to prevent bleeding.

11. The opening in the skin is then dressed without any suture followed by the removal of an intravenous line.

Benefits:

Some of the benefits of this procedure are:

1. Uterine Fibroid Embolization performed under local anesthesia is less invasive than any other available method.

2. No surgical incision is needed except for a small nick which does not require any suture.

3. Patients can resume their usual activities much earlier.

4. There is virtually no blood loss.

5. There is significant improvement and symptom relief in the condition of patients in most cases.

6. Generally, this procedure does not allow fibroids to grow as almost every small or large nodule is treated. Thus, it is a more permanent procedure.

Recovery:

Most patients are discharged on the same day and are given oral pain medications post the procedure. A watery, mucus-like vaginal discharge might be observed within a few days. In some cases, remnants of fibroids are also seen. If there is an infection, it is indicated by fever, chills, and pain and should be immediately reported to the doctor.

Take Away:

Uterine Fibroid Embolization (UFE) is a minimally invasive treatment method for fibroid tumors of the uterus. It does not allow the regrowth of fibroids and is hassle-free. However, it is always advisable to consult a doctor before opting for this method.