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Uterine Fibroid Embolization

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Many women suffer from uterine fibroids. Fibroids are non-cancerous growths in the uterus. In order to treat fibroids, many women have to undergo hysterectomy, that is, removal of uterus. However, not all women are ready to undergo a hysterectomy and opt for uterine fibroid embolization. This is a simple and safe procedure, that provides relief to women who opt for it.

What are Fibroids?

Uterine fibroids are benign tumors of the muscle cells and fibrous tissues of the uterus. These tumors cause no symptoms and often lead to heavy menstrual bleeding, pelvic pain, pressure on the bladder and lower back pain. Pregnant women may suffer a miscarriage due to fibroids.

There are many treatment options available for fibroids. These include hormonal therapy that helps shrink these masses, myomectomy (removal of the fibroids) or hysterectomy (complete removal of the uterus). Another treatment option called uterine fibroid embolization has found medical acceptance and more women opting for it to get rid of fibroids in their uterus.

What is Uterine Fibroid Embolization?

Uterine fibroid embolization is a non surgical procedure wherein the arteries supplying blood to the fibroid are blocked, hereby shrinking the fibroids. It is performed by a Vascular Interventional Radiologist under local anesthesia, rather than a surgeon.

In this procedure, very small particles are injected into the arteries that supplies blood to the fibroids. These particles stick to the vessel wall and form a clot. Thus, blocking blood supply to the fibroids. Once the feed stops, the fibroids begin to shrink and disappear. The commonly used particles are made of polyvinyl alcohol (PAV). This substance has proven to be a safe medical particle for over many years.

As it is a minimally invasive procedure, the tools used are very small. These include catheters and wires. An x-ray, fluoroscopy or ultrasound is used during the procedure.

Why is Uterine Fibroid Embolization Used?

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Uterine fibroid embolization is used in cases where the fibroids develop in premenopausal women. These women may wish to retain their uterus and not get it surgically removed. Some women may want to avoid the effects of prolonged hormonal therapy and some would not want to undergo surgery.

What Happens Before the Fibroid Treatment?

Women who opt for uterine fibroid embolization will be guided by their doctors. You will be asked to undergo certain pre-procedure tests like endometrial biopsy, pelvic imaging, ultrasound or an MRI scan. One should inform their doctor beforehand if they are allergic to latex, certain medications, iodine, contrast agents or gelatin.

One will have to get admitted in the hospital on the day of the procedure. You will have to avoid eating anything at least 4-5 hours before the surgery. However, one can sip a little water. Remove any jewelry or piercing on your body. Wear the hospital gown given before the procedure. The area where the artery will be pinched have to be shaved.

What Happens During the Fibroid Treatment?

Uterine fibroid embolization is carried out by an experienced Interventional Radiologist (IR). The IR will sedate you, so that you remain awake during the procedure, but do not feel any pain. This procedure does not require to be conducted under general anesthesia.

The IR will make a very small cut or nick in the groin area. Here, he will insert a catheter into the femoral artery. With the help of real-time imaging, he will guide the catheter into the artery that supplies blood to the fibroid. Once in place, he will release the tiny particles into the uterine artery. The particles will soon block the blood flow, thus helping the fibroid tumors to shrink and die.

What Happens After the Fibroid Treatment?

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One is required to stay back at the hospital for at least 4 to 24 hours, depending on individual conditions. Many women experience nausea, cramping and abdominal pain after the procedure. The doctor will prescribe pain medications that will help give one some comfort. At times, one may experience fever that will be treated by medications.

It has been found, some women suffer from ‘post-embolization syndrome’. This means, they will complain of flu-like symptoms within a few hours or for a few days after the procedure. These symptoms include:

  • Low grade fever
  • Malaise
  • Mild nausea

After the IR evaluates your condition, one will be made ready for discharge. The patient will be given medications and other instructions by the doctor. One will have to wait for a few days before they resume light activity and get back to their normal work within 11 days.

One week after the procedure, one will have to go in for a post-procedure check-up. After than one is supposed to schedulean appoint after three months. However, the follow-up days may vary, so make sure you ask your doctor beforehand.

What are the Risks Involved?

There are a few risks involved with uterine fibroid embolization. The rate of complications is quite low, but include:

  • Dead tissues of fibroids leading to endometriosis
  • The microspheres or particles flowing or drifting to the wrong artery, leading to damage to other healthy organ
  • Loss of ovarian function leading to infertility, loss of orgasm
  • Hematoma at the incision site
  • Smelly vaginal discharge of pus and blood due to presence of necrotic tissue in the uterus
  • Explusion of full or a part of fibroid through the vagina
  • Failure of embolization, leading to the growth of the fibroid or regrowth in four months

Uterine fibroid embolization has many advantages over hysterectomy, myomectomy and hormonal therapy. However, it may make it difficult to get pregnant after uterine fibroid embolization in a small number of women. There have been reports of pregnancies of many women who have undergone this procedure. One will have significant relief from the monthly pain and heavy bleeding after the procedure. But, it should be noted many women, especially those over the age of 45, enter menopause soon after the procedure. Speak to your doctor regarding all the aspects of uterine fibroid embolization, before you make up your decision regarding your treatment plan.

Written by: Saptakee sengupta
Date last updated: March 13, 2015

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