Uterine fibroid embolisation (UFE) is a minimally invasive procedure to treat fibroid tumours – non-cancerous growths – of the uterus – that cause excessive menstrual bleeding, pain and a lot of pressure on the bladder. Uterine fibroid embolisation is also known as uterine artery embolisation and aims to block the blood vessels supplying blood to the fibroid, causing it to starve, shrink and eventually die. The procedure is done through a flexible tube called catheter to inject tiny particles known as embolic agents into the arteries of the uterus – that supply blood to the uterus and the fibroids.
Uterine fibroid embolisation serves as an alternative to surgery and aims to destroy the fibroid tissue to ease serious symptoms in some women such as:
- Excessive menstrual bleeding
- Pelvic pain
- Swelling in the abdomen
Risks Involved in Uterine Fibroid Embolisation
Uterine fibroid embolisation is a safe procedure, especially for women who are not willing to undergo surgery to treat uterine fibroid embolisation. The risks of complications in the procedure are rare, but some general risks involve include:
- Damage to the other organs
- Possible issues in a future pregnancy
Most fibroids can be treated via the uterine fibroid embolisation; however, if the size of the fibroid is too large, another treatment option may have to be explored.
Reasons to avoid Uterine Fibroid Embolisation
Uterine fibroid embolisation may not be the ideal choice of treatment in cases such as below:
- Existing pregnancy
- Existing chances of pelvic cancer
- Chronic pelvic infection
- Vascular disease
Procedure and Recovery from Uterine Fibroid Embolisation
To prepare for the procedure, the doctor will advise discontinuation of certain medicines, as well as not eating anything post-midnight or per time suggested on the say the day of the surgery. To initiate the surgery, the doctor will put the patient under the influence of anesthesia to reduce pain; then a small incision over the femoral artery in the groin is made to insert a catheter into the artery. The catheter is mounted with a high-definition camera and light that guides the catheter to the uterine arteries. Upon reaching the artery, a contrast fluid such as a dye is inserted into the uterine artery that makes the branches visible on the monitor; it also lights up the fibroids brighter as compared to other tissues –it easier to spot and treat.
Upon identifying the fibroids, the doctor then injects small particles of plastic or gelatin into the blood vessel supplying blood to the fibroids; these particles cause blockage and restrict the supply of blood to the fibroid, leading to starvation and eventually death of the fibroid tissue.
Post the surgery, the patient is kept under observation for a few hours to ensure no complications arise. The patient is supposed to lie flat for a few hours to avoid bleeding at the femoral artery site. Once the anesthesia fades, the patient will experience pain which can be easily managed with pain relievers as prescribed by the doctor. Some people might experience post-embolisation syndrome, such as:
- Mild fever
These symptoms develop 48 hours after the uterine fibroid embolisation and tend to fade away on their own in a week’s time or so. Any complications must be consulted with the doctor. The hospital stay of the surgery is less and the recovery time if fast.
On the next day of the procedure, most women are discharged from the hospital with certain medicines to take for the pain and smooth healing. The pain will subside in a day to two following the procedure.
However, a woman should carefully monitor the recovery process and should seek medical help, in case of conditions such as:
Vaginal discharge: Watery vaginal discharge is very common post the procedure; however, it is expected to fade on its own without any treatment. In case it does not, call for medical help.
Infection: Any signs of infection should be critically monitored such as chills, fever, pain, etc. Moreover, a follow-up meeting with the doctor should be set four weeks after the procedure to check for any signs of infection. Also, three months after the procedure, the doctor might advise an MRI to assess shrinkage or changes in the fibroids or the uterus.
Results of Uterine Fibroid Embolisation
Uterine fibroids embolisation is helpful in removing fibroids and reducing the resultant pain, pressure on the bladder, swelling, etc. In all the procedure provides the following results:
Relief from symptoms: The procedure is very effective and safe, and tends to provide relief from severe patients within 3 months of the surgery. Also, over the following five years post the treatment, it continues to reduce symptoms including heavy bleeding, urinary incontinence and enlargement of the abdomen.
Menstruation: Menstrual cycles continue to come normally post the procedure; however, in case the period is missed, it will resume normal course within a few months. Some women aged 45 or more have a risk of entering menopause after the procedure.
Fertility: The procedure is likely to have negative effects on fertility among women. Though menopause is rare post the procedure, yet certain damage caused to the ovaries can make pregnancy difficult. This also increases pregnancy complications involving placenta. However, even after the procedure, women have had normal pregnancies and no problems.
In all, uterine fibroid embolisation is an effective, safe and barely complicated method to treat fibroids in the uterine; also, its advantages outweigh its disadvantage.