What to Expect During a Uterine Fibriod Embolizaiton
UFE is an image-guided, minimally invasive procedure that uses a high-definition X-ray camera to guide a trained specialist, most commonly an interventional radiologist to introduce a catheter into the uterine arteries to deliver the particles. The procedure is typically performed in a cath lab or occasionally in the operating room.
You will be positioned on the examining table.
You will be connected to monitors that track your heart rate, blood pressure and pulse during the procedure.
A nurse or technologist will insert an I.V. into a vein in your hand or arm so that sedative medication can be given intravenously. You also may receive general anesthesia.
The area of your body where the catheter is to be inserted will be shaved, sterilized and covered with a surgical drape.
Your doctor will numb the area with a local anesthetic.
Using X-ray guidance, a catheter is inserted into your femoral artery, which is located in the groin area. A contrast material is injected to help guide the catheter into your uterine arteries. The embolic agent is released into both the right and left uterine arteries by repositioning the same catheter that was originally inserted. Only one small skin puncture is required for the entire procedure.
At the end of the procedure, the catheter will be removed and pressure will be applied to stop any bleeding. The opening in the skin is then covered with a dressing. No sutures are needed.
Your I.V. will be removed.
You will most likely remain in the hospital overnight so that you may receive pain medications and be observed.
This procedure is usually completed within 90 minutes.
You will feel a slight prick when the needle is inserted into your vein for the I.V. and when the local anesthetic is injected.
The I.V. sedative will make you feel relaxed and sleepy. You may or may not remain awake, depending on how deeply you are sedated.
You may feel slight pressure when the catheter is inserted but no serious discomfort.
As the contrast material passes through your body, you may get a warm feeling.
While you are in the hospital, your pain will be well-controlled with a narcotic.
After staying overnight at the hospital, you should be able to return home the day after the procedure.
You may experience pelvic cramps for several days after your UFE, and possibly mild nausea and low-grade fever. The cramps are most severe during the first 24 hours after the procedure and will improve rapidly over the next several days. While in the hospital, the discomfort usually is well-controlled with pain medication delivered through your I.V.
Once you return home, you will be given prescriptions for pain and other medications to be taken by mouth. You should be able to return to your normal activities within one to two weeks after UFE.
Afterward, it is common for menstrual bleeding to be much less during the first cycle and gradually increase to a new level that is usually greatly improved as compared to before the procedure. Occasionally you may miss a cycle or two or even rarely stop having periods altogether. Relief of bulk-related symptoms usually takes two to three weeks to be noticeable and over a period of months the fibroids to continue to shrink and soften. By six months, the process has usually finished and the amount of symptom improvement will stabilize.
Limitations of Uterine Fibroid Embolization (UFE)
Uterine fibroid embolization should not be performed in women who have no symptoms from their fibroid tumors, when cancer is a possibility, or when there is inflammation or infection in the pelvis. Uterine fibroid embolization also should be avoided in women who are pregnant or in women whose kidneys are not working properly (renal insufficiency).
A woman who is allergic to contrast material (which contains iodine) should be offered a different treatment option.