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Uterine Artery Embolisation | UAE | Fibroids Treatment | Fibroids Surgery | Fibroids Research and Treatment Centre

Uterine Artery Embolisation

Introduction

Uterine artery embolisation (UAE) (sometimes spelt embolization) was first performed to treat symptoms related to fibroids in 1995. Since then many thousands of procedures have been performed worldwide.

It is a minimally invasive treatment which blocks the arteries feeding the fibroids and womb and is performed by an Interventional Radiologist. This is a doctor who has been specially trained in “pinhole surgery” techniques which are used to treat a wide variety of conditions affecting blood vessels. The tools required to perform these treatments ( tubes, called catheters) are inserted into a blood vessel through the skin and directed to the correct site by using X rays and a dye (called radiological contrast) to allow the radiologist to perform the procedure safely.

Uterine artery embolisation takes place in a room much like an operating theatre, but with specialised Xray equipment . Preparation for UAE is much like preparation for an operation in that you will be brought into hospital having had check blood tests and clerking about a week before. You should not eat for 4 hours before the procedure is scheduled, but may drink water. You will be dressed in a hospital gown and a small tube will be put into a vein in your arm, so that you can be given sedatives and pain killers. You may have a catheter inserted into the bladder, too.

It is important that the doctor knows about any allergies you may have especially if you have had a previous allergy to radiological contrast, as this may mean you are not suitable for uterine artery embolisation.

Uterine Artery Embolisation: Technique

This varies slightly between different operators.

You will be asked to lie flat on an X ray table and will have monitoring devices attached to you finger and chest. You may also be given oxygen to breathe through a mask or small tubes placed into your nostrils.

One or both groin areas will be swabbed with antiseptic and then you will be covered in a sterile cloth to keep everything as sterile as possible. The operators will wear a theatre qown and operating gloves.

You will be awake but you may be given some sedatives to make you relaxed. The skin and deeper tissues around the pulse in your groin will be anaesthetised with local anaesthetic and then a needle inserted into the artery. The radiologist then places a guide wire through this needle, the needle is then removed and a catheter is passed over the wire.

The operator uses the X ray equipment to show the position of the catheter and to manipulate it into the correct vessel for the fibroids treatment. The target arteries are the uterine arteries which supply the womb and fibroids. Once the target arteries have been correctly identified and the catheter placed into them, fluid containing thousands of tiny particles is injected until they effectively silt up the artery and block it. The same thing is done on the other side, so that the fibroids and the uterus are starved of blood. The uterus recovers and develops blood supply from other nearby arteries but the fibroids do not.

Once the radiologist is happy that the blood supply has been blocked effectively, the catheters are removed from the circulation and the site where they were inserted is pressed to stop bleeding. The whole uterine artery embolisation procedure usually takes 1 hour, but if difficult, can take 2 hours.

Pain in the pelvis develops after UAE, which is why you will be given strong pain killers. This may be severe for 24-48 hours. Post embolisation syndrome usually follows, which leads to flu’ like symptoms and a mild temperature, and this lasts approximately 5-7 days. Once the pain is controlled adequately by pain killers, you may go home. Generally, hospital stay is 1 -2 days. Once you go home, you should rest for 3-4 days and you should take off at least 2 weeks from work.

Uterine Artery Embolisation: After the Procedure

UAE is a safe procedure, but there are some complications that can arise.

A small bruise at the site of arterial entry in the groin is called a haematoma and is expected. If a large haematoma develops, there is a risk of infection.

A few patients develop a vaginal discharge which persists for several months. If the discharge is copious, it may be due to a fibroid breaking down near the surface of the uterine cavity. This may need a small operation to remove the debris (hysteroscopy and curettage). If the vaginal discharge becomes offensive and is associated with fever and pain, a large piece of fibroid may have become lodged in the cervix, and again this may require removal by a small operation to avoid serious uterine infection.

Infection which does not respond to antibiotics and normal management as above, may require hysterectomy.

A few women have undergone an early menopause. This is more likely to happen in women over 45 years who are closer to the menopause.

Some women have become pregnant after uterine artery embolisation, but it is advised that if you are actively seeking fertility, a surgical operation such as myomectomy, might be a better option. This should be discussed with you by both your gynaecologist and radiologist.

Book An Appointment For Uterine Artery Embolisation

NHS appointments please ask your GP to refer you to the
Myoma Clinic, St George’s Hospital.

If seeking a private consultation please ring 020 8947 9877.

St George’s Fibroids Clinic London | Parkside Hospital Fibroids Clinic Wimbledon
Princess Grace Hospital Fibroids Clinic | St Anthony’s Hospital Fibroids Clinic

Links

  • Women's Health – Women’s Health Clinic Website, Dedicated to Gynecological Disorders. Information on a wide range of women’s health disorders & symptoms women may experience.

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