What is Uterine Artery Embolization for Fibroids

Uterine artery embolization is a procedure to shrink uterine fibroids. Uterine fibroids are masses of tissue (tumors) that can develop in the womb (uterus). They are also called leiomyomas. This type of tumor is not cancerous (benign) and does not spread to other parts of the body outside of the pelvic area. The pelvic area is the part of the body between the hip bones. You can have one or many fibroids. Fibroids can vary in size, shape, weight, and where they grow in the uterus. Some can become quite large.

In this procedure, a thin plastic tube (catheter) is used to inject a chemical that blocks off the blood supply to the fibroid, which causes the fibroid to shrink.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Allergic reactions to medicines or dyes.
• Damage to other structures or organs.
• Infection, including blood infection (septicemia).
• Injury to the uterus from decreased blood supply.
• Lack of menstrual periods (amenorrhea).
• Death of tissue cells (necrosis) around your bladder or vulva.
• Development of a hole between organs or from an organ to the surface of your skin (fistula).
• Blood clot in the legs (deep vein thrombosis) or lung (pulmonary embolus).
• Nausea and vomiting.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• You may be given antibiotic medicine to help prevent infection.
• You may be given medicine to prevent nausea and vomiting (antiemetic).

General instructions

• Ask your health care provider how your surgical site will be marked or identified.
• You may be asked to shower with a germ-killing soap.
• Plan to have someone take you home from the hospital or clinic.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.
• You will be asked to empty your bladder.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
• A small cut (incision) will be made in your groin.
• A catheter will be inserted into the main artery of your leg. The catheter will be guided through the artery to your uterus.
• A series of images will be taken while dye is injected through the catheter in your groin. X-rays are taken at the same time. This is done to provide a road map of the blood supply to your uterus and fibroids.
• Tiny plastic spheres, about the size of sand grains, will be injected through the catheter. Metal coils may be used to help block the artery. The particles will lodge in tiny branches of the uterine artery that supplies blood to the fibroids.
• The procedure will be repeated on the artery that supplies the other side of the uterus.
• The catheter will be removed and pressure will be applied to stop the bleeding.
• A dressing will be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will be given pain medicine as needed.
• You may be given medicine for nausea and vomiting as needed.
• Do not drive for 24 hours if you were given a sedative.

Summary

• Uterine artery embolization is a procedure to shrink uterine fibroids by blocking the blood supply to the fibroid.
• You may be given a sedative and local anesthetic for the procedure.
• A catheter will be inserted into the main artery of your leg. The catheter will be guided through the artery to your uterus.
• After the procedure you will be given pain medicine and medicine for nausea as needed.
• Do not drive for 24 hours if you were given a sedative.

Uterine Artery Embolization for Fibroids, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After your procedure, it is common to have:

• Pelvic cramping. You will be given pain medicine.
• Nausea and vomiting. You may be given medicine to help relieve nausea.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take aspirin. It can cause bleeding.
• Do not drive for 24 hours if you were given a medicine to help you relax (sedative).
• Do not drive or use heavy machinery while taking prescription pain medicine.

General instructions

• Ask your health care provider when you can resume sexual activity.
• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine clear or pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.

Contact a health care provider if:

• You have a fever.
• You have more redness, swelling, or pain around your incision site.
• You have more fluid or blood coming from your incision site.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a rash.
• You have uncontrolled nausea or you cannot eat or drink anything without vomiting.

Get help right away if:

• You have trouble breathing.
• You have chest pain.
• You have severe abdominal pain.
• You have leg pain.
• You become dizzy and faint.

Summary

• After your procedure, it is common to have pelvic cramping. You will be given pain medicine.
• Follow instructions from your health care provider about how to take care of your incision.
• Check your incision area every day for signs of infection.
• Take over-the-counter and prescription medicines only as told by your health care provider.