Fibroids (also known as leiomyoma) are benign (noncancerous) growths in the uterus or womb. They are common in fertile women and usually shrink after menopause.
Fibroids can cause symptoms depending on their size and location. Symptoms include heavy bleeding, pelvic pain, increased period pain, increasing need (frequency) to pass urine and may be associated with infertility.
Uterine Fibroid Embolisation (UFE), also known as Uterine Artery Embolisation (UAE), is a way to treat the symptoms of fibroids without having surgery.
UFE blocks the blood flow to the fibroids so as to reduce the size of the fibroid and decrease the associated symptoms. The uterus (or womb) is not removed. UFE is performed in an angiography suite of a hospital. Angiography is the x-ray examination of blood vessels after a contrast medium (or “dye”) has been injected into the bloodstream. The contrast medium shows up on x-ray images and is used to diagnose any abnormalities.
Contrast medium is a liquid substance injected into an artery or blood vessel. If you have fibroids, the contrast will clearly show on the x-ray images
Patient preparation can vary but usually you will asked to fast or have only a light breakfast prior to the procedure. Blood tests may be requested to see if you have any kidney or blood related problems.
A frequent concern of patients is that they have their period at the time they are to undergo the procedure. UFE is performed from inside the blood vessels, so it doesn’t matter if you are having your period or where you are in your menstrual cycle.
When you arrive for your procedure you will have a drip (or needle) inserted into your arm or the back of your hand. You will then be given an injection of a contract medium (or ‘liquid dye’), that enables the arteries to show up clearly on the x-ray images.
The UFE begins with a needle and wire being placed into the artery, usually the right common femoral artery in the right groin. However, sometimes arteries in the left groin or arm are used. The overlying skin will have been injected with local anesthetic to make it go numb. As you do not have feeling inside the blood vessels, you do not usually feel anything during the procedure. Once the wire is inserted into the artery, a plastic tube known as a catheter is steered into the arteries supplying blood to the fibroids. Most commonly these are the right and left uterine arteries, but also occasionally the ovarian arteries or other arteries supply the fibroids.
Blood supply to the fibroid is stopped by injecting tiny particles of plastic known as polyvinyl alcohol or cis acryl gelatin. Once this has been completed the catheter is removed from the groin and a small clip or stitch is put into the tiny hole in the artery, or firm compression from a finger (of the radiologist or nurse) is applied to the tiny hole in the artery to stop the bleeding. Once the procedure is complete you will be taken back to the ward.
UFE is a medical procedure and there will be some effects experienced immediately after the procedure and for some time later. While you do not usually feel anything during the procedure, it is common to get some degree of pelvic pain or cramping after the procedure, as well as nausea (feeling sick) or vomiting. This is often called ‘post embolisation syndrome’. You will be given medications before and after the procedure to lessen the chance of this happening.
You may also have a temperature (fever) after the UFE. As postembolisation syndrome differs greatly between patients, it does not mean that the UFE did not work if you don’t experience any of these after effects.
On average, UFE takes 60 minutes to perform. The procedure can sometimes take longer, depending on how many arteries need to be blocked, the size of the fibroid or fibroids and the structure of the blood vessels being treated. Following the procedure you usually require an overnight hospital admission for observation.
Like any medical procedure, UFE is associated with some risks or complications. However, these are usually less than with other procedures to treat uterine fibroids including uterine surgery.
The major benefit of UFE is that it is an effective non-surgical treatment for fibroids that cause pain and heavy periods. It is regarded as effective and safe for short and long term treatment of symptomatic fibroids.
It is rare to have after effects from an ultrasound examination.
This information has been reviewed and approved by Dr Ronald Shnier (I-MED Chief Medical Officer).
This information has been reviewed and approved by Dr Ronald Shnier (I-MED Chief Medical Officer).