Uterine Fibroid Embolization

Uterine fibroids, or leiomyomas, are muscular tumors that are typically not cancerous. As the name implies, they form in the uterine wall where they can be the size of an apple seed or grow to the size of a softball. In rare cases, they can be even larger. A woman may have a single fibroid, but it is not unusual for there to be several in the uterus.

While there is no known cause for fibroids, researchers believe that there may be a genetic component. Hormones also seem to play a part in their development. During pregnancy, they will often grow quite rapidly which is attributed to the higher hormonal levels during that time. They respond to anti-hormone medication by shrinking as well as when a woman goes through menopause.

Fibroids may cause some troubling symptoms such as painful periods or heavy bleeding. The lower abdomen may become distended or enlarged. Some women may experience pain in the lower back and during intercourse.

They may also cause problems with pregnancy, labor, and delivery with an increased risk of C-section. In rare cases, they can cause fertility problems.

If you have been diagnosed with fibroids and some of the symptoms have become an issue, your doctor may recommend uterine fibroid embolization.

Here’s what you need to know.

What is a Uterine Fibroid Embolization?

A uterine fibroid embolization procedure is minimally invasive which means less downtime and quicker recovery. It shrinks the fibroids so that related symptoms are significantly relieved. In many cases, the symptoms are completely resolved.

Fluoroscopy, a real-time x-ray, is used to guide the doctor to the correct areas where he or she will deliver embolic agents which are like very fine grains of sand to the arteries that supply blood to the fibroids. These embolic agents block the blood supply to the fibroid, which causes it to shrink. The procedure is safe and very effective with most patients getting relief from their fibroid symptoms.

Who Might Need a UFE?

The primary reason that a woman may elect to undergo a uterine fibroid embolization is to get relief from problematic symptoms that the fibroid or fibroids may be causing. While most fibroids are benign, they can cause pain, pressure, heavy bleeding, anemia, and in rare cases fertility issues. For many women, these symptoms are troublesome enough to warrant undergoing the procedure. Add to that its high efficacy rate, minimal invasiveness, and quicker recovery and it’s obviously a better choice than some other fibroid treatments.

Potential Risks of Uterine Fibroid Embolization

While UFE is an attractive option for most women with fibroids, as with any procedure there are some possible complications. These potential risks include:

• Infection of the puncture site
• Uterine infection
• Uterine injury
• Blood clots
• Injury to the artery
• Hematoma at the puncture site
• Abnormal bleeding
• Temporary or permanent loss of menstrual periods
• Infertility (rare)

Preparing for the Procedure

Your doctor will explain the UFE procedure to you. If you have any questions, don’t be afraid to ask. If you get home and have questions, write them down and schedule a call with your doctor to get the answers you need. And if you are pregnant or think you might be, your provider needs to know.

Once you decide to move forward with your uterine fibroid embolization, you will have some prep work ahead. For instance, you may have to get a pre-op physical to make sure your health is good. This can include blood tests as well as other tests and you may even have to meet with a specialist if you have conditions such as cardiovascular disease or diabetes.

You will be instructed to cease all drinking and eating at least eight hours before your procedure. Typically, this means no food or drink after midnight. You will also be asked about certain conditions, including any allergies to iodine or contrast dye, latex, medications, tape, as well as general or local anesthesia.

You also need to provide your doctor with a complete list of all medications and supplements that you are taking, including over-the-counter medications, prescriptions, and herbal supplements.

If you have a bleeding disorder or if you are taking any medication to thin your blood (including aspirin), your provider needs to know. Omega 3 supplements and ibuprofen also tend to cause minimal thinning of the blood so you may be asked to cease taking them for a few days.

Your doctor may prescribe a medication to help you relax for your procedure. Make sure you get that prescription filled beforehand and take it as your healthcare provider directs as well as any other instructions they give you for preparation of your procedure.

Once you are home, it’s a good idea to have someone there to help you for a few days.

Post-Procedure Care and What to Expect

Once the procedure is complete, the medical staff will apply pressure to the insertion site which will be in your groin. This will stop the bleeding. Once the bleeding has stopped, you will be moved to the recovery room where your pulse, blood pressure, and breathing will be monitored. You will have to lie flat for several hours.

Once you are alert and your vitals are stable, you will either be sent home or moved to your hospital room. This depends on several factors that your doctor will go over with you.

You may experience some cramping in your abdomen so your doctor may prescribe pain medicine. You may also experience a vaginal discharge which can be minimal or moderate. This will also be monitored by nursing staff.

Within a few hours of the procedure, you will be encouraged to sit up, get up, and move around. You may also be given deep breathing exercises to do or instructed to cough. These exercises are important for your well-being, so you need to be diligent in doing them.

Post-procedure you may be given some ice shavings, then in a few hours graduate to liquids. If you can tolerate that, you will be gradually transitioned to foods that are more solid.

The most important part of your uterine fibroid embolization procedure is following your doctor’s and nurses’ instructions to the best of your ability. They have your best interest at heart and doing what they advise will help make your recovery much easier.