Uterine Artery Embolisation

Fibroid – common and benign (non-cancer) growth of muscle in the uterus
Adenomyosis – growth of the lining or glands of the uterus into the muscle layer

What is Uterine Artery Embolisation?

Uterine artery embolisation is a safe and effective treatment for benign (non-cancerous) uterine fibroids, as well as adenomyosis, that has been performed for over 25 years. It is for patients with fibroids and/or adenomyosis that causes symptoms like heavy menstrual bleeding (heavy periods) or a feeling of fullness in the lower abdomen. The fullness can cause frequent urination. The treatment is called “embolisation,” which blocks the blood supply to the fibroid and/or adenomyosis tissue, causing it to become inactive and shrink.

What does the procedure involve?

A specialist interventional radiologist will first consult and examine you in the outpatient clinic to assess your suitability for the procedure. The doctor will ask about your symptoms, your past medical and surgical history, and review the results of previous investigations.
If you are suitable and wish to undergo the procedure, you will be booked for an overnight stay in hospital. The procedure is performed with local anaesthetic and sedation (“twilight anaesthetic”) under ultrasound and x-ray guidance.
A small tube (catheter) is inserted into the artery of your groin and will be fed into the artery that supplies the uterus and fibroids. The doctor will then inject particles (similar to small beads) into the artery. This blocks the blood flow to the fibroid and/or adenomyosis tissue and causes it to become inactive and shrink.
The procedure itself is usually not painful, other than the initial sting of local anaesthetic, but after the procedure it is common to experience crampy pains in the pelvis, a mild temperature (fever) and nausea for up to 6 to 8 hours. This is called “post-embolisation syndrome” and typically peaks at 4 to 6 hours after the operation, before then decreasing. You will stay in hospital overnight and be given medication for this.

What are the benefits of Uterine Artery Embolisation?

There is minimal scarring at the needle insertion site after the procedure
Recovery and return-to-work times are typically shorter than after surgery.
Your period will typically be lighter in volume from approximately 2 to 3 months following the treatment
The fibroid tissue shrinks gradually over 6 to 12 months following treatment, and for most people (80%) will no longer cause symptoms

Other options to Uterine Artery Embolisation?

Conservative treatments including contraceptive and hormonal medications, and intrauterine devices (IUD)
Surgical removal (myomectomy or hysterectomy)

Before being booked for uterine artery embolisation, it is a good idea to discuss other options with your GP and Gynaecologist. We like you to be fully informed about all options before deciding.

What if I decide not to have the procedure?

If you would not like to proceed with uterine artery embolisation or it is unsuitable for you, our team will discuss other options with you and arrange referral to other practitioners as appropriate

Your current medications

It is important to tell your care team about any allergies you have and treatments or medications you may be taking, including non-prescription medications, vitamins or herbal remedies. Typically, you can continue with your usual medications without interruption, but this should be confirmed with your care team.

In particular, please inform the treating team of any anticoagulation (blood thinner) medication you are taking.

What complications can happen?

Overall, the rate of complications is low, however possible complications include:

Infection (2-3%)
Fibroid expulsion (passage of fragments through the vagina) (less than 1%)
Bleeding or a large bruise in the groin (2%)

Uterine artery embolisation is effective in approximately 80% of women, however it is not effective for everyone, and up to 20% of women may need further treatment in the future.

Can I get pregnant after uterine artery embolisation?

Uterine artery embolisation does not make you infertile and women have achieved successful pregnancies following the procedure. However, the relative chances of you being able to become pregnant after embolisation are uncertain, and there are many factors that may affect fertility.

It is important that you discuss your future plans regarding pregnancy with the doctor at your clinic appointment and ask any questions you may have.

How soon will I recover?

Most women are able to go home the following day after the procedure and return to light activities within 2 – 3 days. Most women are able to return to work and exercise within 2 weeks.

Summary

Uterine artery embolisation is a treatment for uterine fibroids and/or adenomyosis causing symptoms such as heavy periods or pelvic fullness with increased urinary frequency
The procedure uses particles to block blood supply to the fibroid and/or adenomyosis tissue
It is performed under local anaesthetic and sedation, with an overnight stay in hospital, and most patients are able to return home the following morning
The rate of complications is low and similar to surgical removal