Uterine Artery Embolisation
What is Uterine Artery Embolisation?
This is a minimally invasive procedure where blood supply to the fibroid uterus is blocked. This deprives the fibroids of oxygen and nutrients causing them to shrink. This procedure leads to reduction in size of the fibroids and improvement of symptoms but does not remove the fibroids. This procedure is carried out by specialist doctors called as interventional radiologists.
What investigations are required?
If you choose to have this procedure, your gynaecologist will refer you to an interventional radiologist. You will need to undergo both a consultation and MRI scan to determine the suitability of this treatment method. Blood test would also be required to check your haemoglobin and iron levels as well as kidney function.
Which fibroids would be suitable for this procedure?
Most fibroids would be suitable for this procedure except the very large and very small. A typical woman having this procedure will be in her forties and will have completed her family.
How is this procedure performed?
Uterine artery embolisation is carried out as an inpatient procedure requiring 2-3 days of hospital stay. It is usually carried out under intravenous sedation or short general anaesthesia. Some women may also be able to stay awake during the procedure and just have some pain relief.
A small incision is made in one of the groins and a catheter is inserted under radiographic guidance. This catheter is then moved up to each of the uterine vessels and tiny particles are injected blocking the blood supply to the fibroids.
The procedure usually takes 60-90 minutes and recovery is on the gynaecology ward under nursing supervision. There is some pain to be expected and you will have enough pain-relief prescribed to make it manageable.
What are the chances of success?
This is a very effective way of treating symptomatic fibroids. 80-90% of women get complete or significant relief of symptoms such as heavy periods and pressure symptoms. The volume of fibroids goes down by 40-60%.
The effect is likely to last for up to five years but may last for longer.
Are there any risks associated with this procedure?
The procedure is associated with some pain and admission is required for 2-3 days for pain relief. There will be some discomfort and mild fever for a few days afterwards. There is sometimes watery vaginal discharge which in some cases can become purulent and offensive. There is a small risk of developing infection which is usually successfully treated by antibiotics but a very small proportion (less than 1%) may need a hysterectomy for extensive infection and sepsis.
Sometimes blood supply to the ovaries is also partially affected and there is 1-4% risk of premature menopause.
How quick is the recovery?
Recovery is usually quick and most women are able to resume normal duties during 1-2 weeks.
Where is this procedure performed?
This procedure can be performed at The Portland or The Wellington hospitals under the care of an interventional radiologist.