UFE is performed in a hospital by an Interventional Radiologist who is specially trained in vascular embolization procedures. UFE involves the following steps:
Conscious sedation is given through an intravenous line placed in the arm. This will make you very relaxed and sleepy. Most women have no recollection of the procedure after it is over. The radiologist will also give you a local anesthetic at the groin puncture site. Optionally an epidural or spinal anesthetic is used. Your Interventional Radiologist will discuss anesthetic options with you at your initial consultation.
Once the local skin is numbed up, the doctor makes a small skin nick (less than one-eighth of an inch in length) at the top of your leg near the crease between the leg and pelvis. The doctor then advances a tiny plastic tube (catheter) the size of a piece of angel hair pasta through the puncture site into the femoral artery which lies just under the skin. Using x-ray imaging, the doctor then precisely guides a tiny micro-catheter into one, then the other uterine artery. There are two uterine arteries, one on each side. The doctor can usually enter both arteries from a single puncture site in the right groin.
Once the catheter is in the appropriate position, the doctor injects tiny spherical particles of biocompatible plastic (about the size of grains of sand) into the uterine blood vessels. These particles enter the uterine blood vessels only and do not effecting other blood vessels in the pelvis. The particles remain permanently in the blood vessels supplying the fibroid tumors, blocking their blood flow. This is called embolization. This cuts off the blood flow and causes the tumor (or tumors) to shrink. The skin puncture where the catheter was inserted is cleaned and covered with a bandage.
The entire procedure takes approximately one hour. This cuts off the blood flow and causes the tumor or tumors to shrink.
UFE requires an overnight stay in the hospital for observation in supervised recovery. During the initial six to eight hours after the procedure, the fibroids cause pain or cramping as they die and start to shrink. But this pain can be relieved with medication, often in the form of a self-administered pain-killing medication pump or a continuation of the epidural or spinal anesthetic. Some women may also experience nausea or have a low grade fever during this initial recovery period. However, most patients feel much better by the next morning and are ready to go home.
The first few days may be difficult due to some continued pelvic pain. You should rest at home as needed and take pain medication prescribed by your doctor. Usually you will have sufficiently recovered within one week of the procedure to resume normal daily activities or return to work if desired.
The Interventional Radiologist will follow-up with you to make sure you are recovering as expected. it is important to have follow-up visits with your gynecologist to track your recovery and the success of the UFE treatment. In the majority of patients, there is a dramatic decrease in all related fibroid symptoms such as heavy menstrual bleeding, cramping, pelvic pain and frequent urination. An MRI is usually performed approximately 6 months after the procedure to assess your fibroid condition. Usually the fibroids have significantly decreased in size or are non-existent.
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