Uterine Artery Embolization (UAE)

Uterine Artery Embolization (UAE) is a minimally invasive procedure that treats uterine fibroids, which are non-cancerous growths in the uterus that can cause pain, heavy bleeding, and other symptoms. This procedure works by blocking the blood flow to the fibroids, causing them to shrink and reducing associated symptoms. At Prospero Vascular, our skilled interventional radiologists perform UAE with precision, offering women an effective alternative to traditional surgical options like hysterectomy or myomectomy.

What is Uterine Artery Embolization?

Uterine Artery Embolization is a procedure that treats uterine fibroids by selectively blocking the blood vessels (arteries) that supply blood to the fibroids. Fibroids are benign tumors that can develop within the walls of the uterus. While many fibroids are asymptomatic, larger or multiple fibroids can lead to significant symptoms such as:

• Heavy menstrual bleeding
• Pelvic pain or pressure
• Frequent urination
• Pain during sexual intercourse
• Enlarged abdomen

During UAE, an interventional radiologist inserts a catheter into the femoral artery (in the groin) or sometimes through the wrist. Using real-time imaging guidance, the doctor navigates the catheter to the uterine arteries that supply blood to the fibroids. The doctor then injects tiny particles, or embolic agents, into these arteries to block the blood flow, causing the fibroids to shrink and the symptoms to resolve.

Why is Uterine Artery Embolization Performed?

Doctors typically perform UAE for women who experience symptoms related to uterine fibroids and are looking for a treatment option that avoids traditional surgery. It is especially beneficial for women who:

• Want to avoid a hysterectomy (removal of the uterus)
• Prefer a less invasive alternative to surgical procedures
• Have fibroids that are causing significant symptoms, such as heavy bleeding, pain, or pressure
• Discuss future pregnancy plans with your treating clinician before choosing UAE.
• Wish to avoid, or are not candidates for, a more invasive surgery.
• The procedure not only treats the fibroids but also provides significant symptom relief, improving quality of life for women affected by this condition.

Who is a Candidate for Uterine Artery Embolization?

Doctors generally recommend Uterine Artery Embolization for women who are experiencing symptoms related to uterine fibroids and meet certain criteria. Ideal candidates for UAE include women who:

• Have symptomatic uterine fibroids, such as heavy menstrual bleeding, pelvic pain, or pressure
• Do not wish to undergo a hysterectomy or prefer a non-surgical approach
• Are done having children or do not wish to become pregnant, as pregnancy after UAE is rare and may be more complicated
• Have fibroids that are causing significant discomfort or other issues but are not associated with cancer
• Can undergo the procedure after individualized medical evaluation.
• It’s important to note that UAE is not recommended for all women with fibroids. If the fibroids are particularly large, numerous, or in certain locations within the uterus, UAE may not be appropriate. Your healthcare provider will evaluate your specific condition and discuss the most appropriate treatment options with you.

How Does the Uterine Artery Embolization Procedure Work?

An interventional radiologist performs Uterine Artery Embolization in a specialized procedure room, typically under local anesthesia and sedation to ensure patient comfort. The procedure generally takes 1 to 2 hours and involves the following steps:

• Preparation: The care team will ask you to lie on an examination table. The care team cleans and sterilizes the insertion area, usually the groin or wrist. The doctor uses a local anesthetic to numb the insertion site.
• Catheter Insertion: The doctor makes a small incision at the insertion site and guides a thin tube, called a catheter, into the femoral artery (groin) or radial artery (wrist). The doctor advances the catheter under real-time imaging, such as fluoroscopy or X-ray, to the uterine arteries.
• Embolic Agent Injection: Once the catheter is positioned in the uterine arteries, the doctor injects small particles (called embolic agents) into the arteries that supply blood to the fibroids. These particles block the blood flow to the fibroids, causing them to shrink and die over time.
• Monitoring: The interventional radiologist monitors the procedure with imaging to ensure the proper placement of the catheter and that the embolic agents are effectively blocking the blood flow to the fibroids.
• Completion: Once the doctor completes the procedure, they remove the catheter and applies pressure to the insertion site to prevent bleeding. The care team then applies a bandage and monitors you for a short time before you go home.
• UAE is a minimally invasive procedure, meaning it does not require a large incision or general anesthesia, and patients can typically return home the same day.

What to Expect After Uterine Artery Embolization

After undergoing Uterine Artery Embolization, most women are able to return home the same day. However, recovery time may vary depending on individual circumstances. Here’s what you can expect after the procedure:

• Mild Discomfort: Some cramping or pelvic pain is common after the procedure and may last for a few days. Over-the-counter pain medication is typically sufficient to manage the discomfort.
• Rest and Recovery: You may be advised to rest for 1-2 days after the procedure, as your body adjusts to the changes caused by the embolization.
• Post-Procedure Monitoring: After the procedure, the care team may monitor you for a few hours to ensure there are no complications. The care team may schedule follow-up visits or imaging studies to monitor the fibroid shrinkage.
• Activity Restrictions: Most women can return to light activities within a few days but should avoid strenuous exercise or heavy lifting for several weeks. Your doctor will provide specific instructions for post-procedure care.
• Symptoms Improvement: Many women begin to notice improvement in their symptoms, such as a reduction in bleeding and pain, within 1-2 weeks after the procedure. Full results may take several months as the fibroids shrink.

Benefits of Uterine Artery Embolization

Uterine Artery Embolization offers several benefits over traditional surgical options, including:

• Minimally invasive: UAE is performed through a small incision and does not require the removal of tissue or organs. This results in less pain, smaller scars, and a faster recovery time compared to surgery.
• Effective symptom relief: The procedure significantly reduces or eliminates symptoms caused by uterine fibroids, such as heavy bleeding, pelvic pain, and pressure.
• Preserves the uterus: Unlike a hysterectomy, UAE allows women to keep their uterus, which may be important for those who want to preserve their reproductive organs or avoid the complications of a hysterectomy.
• Shorter recovery time: UAE typically requires only a few days of recovery, whereas traditional surgery can involve weeks of downtime and a longer recovery period.
• Outpatient procedure: Most women can undergo UAE as an outpatient procedure, meaning they can return home the same day without the need for a hospital stay.
• UAE offers a non-surgical option for women with uterine fibroids, providing effective symptom relief with fewer risks and a quicker recovery time than traditional surgery.

Risks and Complications

Although Uterine Artery Embolization is a safe and well-tolerated procedure, like all medical procedures, it carries some risks and potential complications. These may include:

• Infection: As with any invasive procedure, there is a small risk of infection at the catheter insertion site.
• Pain or Cramping: Some cramping or pelvic pain may occur after the procedure, though it is usually temporary and can be managed with medication.
• Menstrual Irregularities: Some women may experience changes in their menstrual cycle, including lighter or irregular periods.
• Premature Menopause: In rare cases, UAE may lead to early menopause, particularly in women over the age of 45, as the procedure can affect ovarian function.
• Fibroid Expulsion: In rare cases, fibroids may become expelled from the uterus after embolization, causing discomfort or bleeding.
• Non-Complete Embolization: In some cases, UAE may not effectively shrink all fibroids, and you may need additional treatments.
• Your healthcare provider will discuss these risks with you during your consultation and help determine if UAE is the right option based on your health and specific condition.

When to Consider Alternative Treatments

While UAE is an effective treatment for uterine fibroids, it may not be the best option for every patient. Alternative treatments include:

• Hysterectomy: The surgical removal of the uterus, which is the most definitive treatment for fibroids but also involves a longer recovery and potential loss of fertility.
• Myomectomy: Surgical removal of the fibroids while preserving the uterus, suitable for women who wish to maintain fertility.
• Medications: Hormonal treatments or other medications may be used to manage symptoms temporarily but do not treat the fibroids directly.
• MRI-guided Focused Ultrasound: A non-invasive treatment that uses ultrasound waves to target and destroy fibroids.
• Your healthcare provider will discuss these options with you to determine the most appropriate course of treatment for your specific situation.

Why Choose Prospero Vascular?

At Prospero Vascular, we specialize in providing comprehensive care for women with uterine fibroids through advanced, minimally invasive treatments like Uterine Artery Embolization. Our team of interventional radiologists uses state-of-the-art technology to ensure the best possible outcomes, with a focus on patient comfort and recovery.

Schedule a Consultation

If you are experiencing symptoms of uterine fibroids and want to learn more about Uterine Artery Embolization, contact Prospero Vascular today to schedule a consultation. Our experienced team will help guide you through the options available and provide personalized care tailored to your needs.

Frequently Asked Questions

Information on this page is educational and does not replace an individual medical evaluation. Please discuss expected benefits, alternatives, and risks with your treating clinician.