Uterine fibroid embolization (UFE)
The procedure is also known as the UFE – blocking the patency of the artery supplying a myoma.
Why would you need the intervention?
In case of prolonged and heavy menstrual bleeding or pelvic pain which may be associated with myomas, in case of a pronounced pressure on the urinary bladder or colon by myomas and discomforts associated with the pressure.
When would you need the intervention?
The intervention would be indicated if the medications prescribed by a gynecologist do not help to reduce or relieve symptoms or if the traditional gynecological surgery to remove myoma or uterus proves to be impossible to be performed or a patient refuses to undergo the traditional surgical procedure.
Which radiological examination is required before indicating an intervention?
Magnetic resonance imaging – Pelvic MRI and MRI angiography of uterine arteries
What does the intervention include?
Uterine artery embolization is performed under local anesthesia while a patient is sedated. A thin catheter is inserted through the femoral or radial artery and is threaded to the targeted artery (the uterine artery). The injection containing 300-900 µm of small polyvynil particles is infused to achieve embolization i.e. oclussion of the smallest blood vessels which supply a myoma. Embolization causes the devascularization and hyalinization of a myoma, which consequently reduces. The procedure is performed bilaterally and usually takes approximately 60-90 minutes. The intervention ends by pressuring the catheter insertion site with hands or by using an additional agent to close the insertion site.
Should a patient expect some discomforts during and after the intervention?
The only significant discomfort is usually the pain caused by a blood flow blockage in the uterine artery, which occurs due to a temporary insufficient oxygenated blood supply. The pain starts after these small particles block the blood flow of the small uterine arteries and usually lasts for 24 to 48 hours. Since the pain is expected in all patients, an anesthesiologist helps to take all therapeutic measures in order to significantly reduce or eliminate the pain before, during and after the intervention.
A patient can return to his daily routine 5 days after the intervention.
What result should a patient expect from the intervention?
After the uterine artery and myoma embolization, a patient can expect a significant improvement regarding abnormal vaginal bleeding, pain relief and the relief of the pressure in the pelvis. These improvements are caused by the reduction of a myoma and its blood supply.
How to get prepared?
A patient is to come on an empty stomach and shall not smoke before the intervention (at least for 6 hours). A patient should have his groins shaved.
Related tests and examinations:
A patient should bring laboratory test results (creatinine blood and prothrombin time are obligatory).