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Uterine Artery Embolization for Fibroids

WHAT YOU NEED TO KNOW:

What do I need to know about uterine artery embolization for fibroids?

This procedure may also be called uterine fibroid embolization. Embolization means creating a clot, or block, in a blood vessel. Your healthcare provider will block an artery that supplies blood to your uterus and the fibroid. This will make the fibroid shrink because it will not get nutrients and oxygen. The fibroid will not be gone, but it will become smaller and stop pressing on nearby organs and tissues. This may help relieve symptoms fibroids can cause, such as abnormal uterine bleeding, pain, and bloating. Embolization may be used if you cannot or do not want to have a hysterectomy to remove your uterus. Your uterus will not be damaged by a block to the blood flow.

How do I prepare for the procedure?

  • Your provider will tell you how to prepare for this procedure. You may be told not to eat or drink anything after midnight the night before your procedure. Arrange to have someone drive you home. The person should stay with you to help you and watch for problems that may develop. Tell your provider about all your allergies. This includes if you have ever had an allergic reaction to contrast liquid, anesthesia, or antibiotics.
  • Give your provider a list of your medicines. Include all medicines and supplements you take. You may need to stop taking blood thinners or aspirin several days before your procedure. This will help decrease your risk for bleeding. Do not stop taking medicines unless your healthcare provider tells you to stop. Your provider will tell you which medicines to take or not take on the day of your procedure.
  • You may need blood tests to check how well your blood clots and to check your kidney function. You may also need an MRI. An MRI may show that you have more than one fibroid. Each fibroid will be checked for size, location, and how it is attached to your uterus. Do not enter the MRI room with anything metal. The metal can cause serious injury. Tell your provider if you have any metal in or on your body.
  • This procedure is not used during pregnancy. You will be given a blood or urine test to make sure you are not pregnant. Talk to your provider about your plans for pregnancy in the future. You may have a harder time becoming pregnant or carrying a baby to term after this procedure.
  • Talk to your provider if you use an intrauterine device (IUD) if he or she did not place it for you. Tell him or her when it was placed and what kind it is. It is okay to have an MRI and uterine artery embolization with an IUD. You may need an antibiotic to prevent an infection caused by bacteria. Tell your provider if you had an allergic reaction to an antibiotic.

What will happen during the procedure?

  • You may be given general anesthesia to keep you asleep and pain-free. More commonly, moderate sedation is used. This means you will be awake during the procedure, but you should not feel any pain. Your provider will put numbing medicine on your skin where the procedure will be done. A small incision will be made over an artery in your leg, near your groin. A catheter (thin tube) will be guided into the artery. Contrast liquid will be used to help your healthcare provider see your arteries more easily.
  • Your provider will use a type of x-ray that gives a moving picture of the arteries. This will help him or her move the catheter into the right place. The catheter is moved up until it reaches the uterine artery. The artery supplies blood to the fibroid. Liquid that contains small pieces of material is put into the artery. The pieces block blood flow to the uterus and fibroid. This keeps the fibroid from getting nutrients and oxygen. The fibroid stops growing, dies, and becomes smaller. This procedure is repeated on the uterine artery on the other side. If you have more than one fibroid, they can all be treated during the same procedure.
  • Your provider will remove the catheter when both sides are finished. Pressure will be put on your skin over the catheter site to stop any bleeding. The incision area does not need to be closed with stitches. It will be small and close on its own. The area will be covered with a bandage to prevent infection.

What should I expect after the procedure?

  • You will probably have pain and cramping for a few days in your uterus. You may also have pain, bleeding, or bruising where the catheter went into your leg. All of these symptoms are normal and should get better soon.
  • You should expect to stay in the hospital overnight. You may be given medicine to relieve inflammation. You may also be given pain medicine through your IV or a pump. A pump allows you to control when the pain medicine is given. Pain usually lasts 24 to 72 hours, but you may have pain for up to 1 month. You should also expect some discharge from your vagina. This should not last longer than 1 month.
  • Healthcare providers will help you walk around after your procedure. This will help prevent blood clots. Do not get up until healthcare providers say it is okay. They may want you to lie in one position for a certain amount of time. When they say it is okay to walk, they will help you stand and walk safely.
  • Your body will need to break down the fibroid. This will take a few months. You should start to notice relief from your symptoms within a few weeks.

What are the risks of uterine artery embolization for fibroids?

  • You may bleed more than expected or develop an infection. Your arteries may be damaged from the catheter, or you may develop a blood clot. Your kidneys may be damaged from the contrast liquid. Your uterus may be damaged, and it may need to be removed. You may develop an abscess (pocket of pus) in your uterus. Your monthly periods may stop. You may develop a urinary tract infection (UTI) or have trouble urinating. The procedure may not relieve your symptoms. The fibroid may grow back. Fibroids can come away from the uterus. You may pass small pieces from your vagina if this happens. A procedure called a dilation and curettage (D&C) is used to make sure all pieces are removed.
  • If you become pregnant, your risk for a caesarian section (C-section) or miscarriage will increase. You may also bleed heavily from your uterus after you deliver a baby. If you are older than 45, embolization may cause menopause to start. Rarely, you may need to have ovarian arteries blocked during this procedure. This can affect the function of your ovaries.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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