The basic principle of uterine fibroid embloization (UFE) is
blocking the arteries that supply blood to the fibroids. The blockage is
created by injecting small particles in the arteries. That's why uterine
fibroid embolization is also known as uterine artery embolization (UAE). The
blockage of the blood supply will cause degeneration of the fibroids.
The UFE procedure was first applied in fibroids patients in France as a means
of reducing the blood loss that occurs during myomectomy. It was then
discovered that after the embolization, the fibroids symptoms went away and
further surgery was no longer needed.
The UFE Procedure
First, a needle is used to enter the artery to create access
for the catheter. Before the embolization is started, an arteriogram is carried
out to provide road map of the blood supply to the uterus and fibroids.
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| Catheter inserted into the artery |
After that, particles of polyvinyl alcohol (PVA) are
injected slowly with x-ray guidance. After several minutes, the arteries are
completely blocked. Once one side is completed, the other side is embolized.
Arterial flow will still be present to some extent to the normal portions of
the uterus, but flow to the fibroids is blocked. This procedure takes
approximately 1-1.5 hours and usually done in the hospital with an overnight
stay after the procedure.
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| PVA blocked the blood supply to the fibroids |
The Side Effects
Several hours of moderate to severe pain will be experienced
by most UFE patients. Most UFE patients are hospitalized overnight and those
symptoms are usually improved by the next morning, when the patients are
allowed to go home. After that, patients may have periodic moderate to severe
cramping for several days.
Patients may also feel tired, have a fever or nausea
periodically. All these symptoms will be diminish after several days, but may
last longer. For working women, they can usually go back to work in 7-14 days
after the procedure.
The Complications
Complications after UFE are quite rare. However some
complications that may occur after UFE procedures include;
-Injury to the uterus from decreased blood supply or
infection.
- Injuries to other pelvic organs.
The good news is these complications is almost impossible
and happened in less than 1% of patients.
The long term complications causing by x-ray exposure during
embolization are not expected. However, a study measuring x-ray exposure was
found to be below the level that can be harmful to the patient herself or
future children.
The Possibility of Pregnancy After UFE
Actually UFE is not recommended for women who are still
willing to carry babies since the outcome of pregnancy following UFE is not
known.
Most women that had this procedure are finished with
childbearing and only few of them have tried to become pregnant after UFE. So
far, at least a dozen patients have become pregnant after UFE worldwide.
Another uncertain fact is whether this procedure affects the
menstrual cycle. Most of the UFE patients were reported to decrease bleeding
with normal menstrual cycles and only few of them have lost their periods after
having UFE. However, it's uncertain and still need further study whether these
cases are a result of decreasing ovarian function resulting from this UFE
procedure.
The Expected Results
Nowadays, about 3000 patients have already had this
procedure and most of them rated this procedure as very tolerable.
The expected reduction in the volume of the fibroids is 50%
in 3 months. However, it's not yet known if the fibroids can regrow after
embolization.
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