Once you and your doctors(s) have determined that Uterine Fibroid Embolization (UFE) is the right fibroid treatment option for you, here are some of the things you’ll need to know before, during and after treatment.
Your Interventional Radiologist (IR) will explain to you in detail all of the pre-procedure tests prescribed. Also during your consult, you should let your doctor know if you are allergic to any medications, shellfish, iodine, contrast agents, or gelatin to minimize the risk of a reaction as a result of the fibroid treatment procedure. You and your doctor also should decide what type of sedation will work best for you. Most doctors use conscious sedation, which means you will be awake during the procedure but you will feel groggy.
UFE is performed as an outpatient fibroid treatment procedure in a hospital and will typically require a stay up to 23 hours. After you arrive at the hospital, you will be prepped for the procedure by the Radiology staff. This includes initiating the sedation and other medication discussed during your consult. Other medications to help manage post-procedure effects may also be administered at this time. It is important to discuss with your IR which medications will be used in the management of your post-procedure care. Once you feel groggy or sleepy, you will be moved to the Radiology Suite, where the fibroid treatment will be performed.
Uterine Fibroid Embolization Treatment
Uterine fibroid embolization, also known as uterine artery embolization is a minimally invasive procedure that is performed by an Interventional Radiologist (IR), a medical doctor with extensive experience in minimally invasive procedures. Prior to the procedure, some tests may have to be done. The entire fibroid treatment typically lasts less than one hour, and is performed as an outpatient therapy. Patients usually have to stay up to 23 hours after the procedure is complete.
The uterine fibroid embolization procedure begins with a tiny incision in the femoral artery. This incision provides the IR with access to the femoral artery in the upper thigh. Using specialized X-ray equipment, the IR passes a catheter (small tube) into the femoral artery, to the uterine artery, and guides it near the location of the fibroid tumor. When the IR has reached the location of the fibroids, embolic material (small spheres) are injected through the catheter and into the blood flow leading to the uterine fibroid tumors.
The embolic material is designed to block the vessels around the fibroid, depriving it of the blood and oxygen it needs to grow. The blood and oxygen deprivation results in fibroids shrinking. The embolic material remains permanently in the blood vessels at the fibroid site.
The catheter is then moved to the other side of the uterus, usually using the same incision in the thigh. Once the IR has completed embolization of the uterine artery on both sides, the catheter is gently removed and the IR places finger pressure over the small incision in your thigh. After holding the puncture site for a few minutes to help stop any bleeding, the IR may close the incision using a vascular closure device.
After the procedure, you may experience some discomfort such as abdominal cramping or pain. You and your doctor will determine what medications may be needed to keep you comfortable. The post-procedure care that you receive will be administered by skilled nurses and your IR. Post procedure appointments will need to be scheduled, and since these appointments vary, be sure to ask your IR when they need to be scheduled.
Most women experience some degree of abdominal pain or cramping (similar to menstrual cramps) shortly after this treatment for uterine fibroids. Your doctor will decide what medications you will need to keep you comfortable. Generally patients receive medications for pain management. Occasionally a patient experiences fever, which is usually treated with medication. Some patients experience nausea related to medications and they can be changed accordingly. You will remain in an observation unit up to 23 hours, depending upon the decision of your physician.
Some patients may experience “post-embolization syndrome” following the uterine fibroid treatment which is described as having flu-like symptoms, such as a low grade fever, malaise (a vague feeling of discomfort), and mild nausea. Post-embolization syndrome can occur within a few hours or up to a few days after uterine fibroid embolization.
Once your IR has evaluated you and has decided you are ready for discharge, you will receive discharge instructions from your doctor. These instructions include information on post uterine fibroid treatment care regarding medications you will need to take to keep you comfortable based on how you are feeling. They may also include information on when you can expect to begin returning to normal activities, as well as all phone numbers for whom to call if you have questions. You may continue to experience some cramping, similar to menstrual period cramping, that lasts a few days after the procedure. Most women are able to return to light activity within a few days of the uterine fibroid embolization treatment and are usually back to work and normal activity on average, within 11 days.
Finally, your IR will schedule your post-procedure appointments to check your recovery. Typical timeframes for these appointments are one week post-procedure, and three months post-procedure. Since follow up appointments do vary, be sure to ask when these appointments should be scheduled.