UTERINE FIBROID EMBOLIZATION
UTERINE FIBROID EMBOLIZATION?
Uterine fibroid embolization (UFE) is a minimally invasive procedure to treat fibroids. Fibroids are the most common uterine tumor and affect an estimated 25-40% of women. While benign, these small tumors can cause symptoms, such as pelvic pain, heavy menstrual bleeding, cramping and pressure on pelvic organs, such as the urinary bladder and intestines.
Until recently, fibroids were typically treated by performing a hysterectomy (removal of the uterus). However, new technology allows for minimally invasive treatment options that reduce recovery times. Uterine fibroid embolization is an interventional procedure that uses a small catheter to reach the uterine arteries. An interventional radiologist injects inert particles to block the supply of blood to the uterine fibroids, ultimately causing them to shrink.
Who should have uterine fibroid embolization?
Your doctor can help you understand if uterine fibroid embolization is for you. The procedure is safe and effective for appropriately selected patients, who must be screened by physical examination, gynecological history and MRI imaging prior to the procedure.
How to prepare for uterine fibroid embolization
Uterine fibroid embolization is a specialized procedure. Because of this, some special preparation is needed before your procedure.
- Arrange for someone to drive you home after the procedure.
- Discontinue any of the following medications for 3 days prior to your procedure: Plavix, Pletal, Ticlid, Trental, Coumadin, Warfarin, Brilinta, Xarelto or Pradaxa.
- Discontinue Effient for 7 days prior to your procedure. Patients who have had a drug eluting cardiac stent within the past year should not stop Plavix or Effient.
- Discontinue any of the following medicines 24 hour prior to your procedure: Lovenox, Fragmin, Nomiflo, Orgaran, Innohep, Arixtra, Eliquis or Iprivask.
- If you are on insulin, take half of your dose the morning of the procedure. Do not take any oral diabetic medication the morning of the procedure.
- All other medications are okay to take the day of the procedure. Take all your medications with small sips of water, unless told otherwise. It is very important to take blood pressure medications the morning of your examination. You will be told to stop taking blood thinners. This is important to prevent bleeding problems after your exam.
- Please bring all your medications with you to your appointment (not just a list).
- Do not eat solid foods for 6 hours prior to your procedure. You may drink clear liquids until 2 hours before the procedure (no milk or creamer, no juice with pulp).
- If you have had imaging done prior to your procedure, please arrive 30 minutes before your appointment time.
- Inform the nurse and the radiologist of any allergies you have.
- Please fill out and bring the documents and questionnaire about your current health status, including current problems, allergies, medications, surgeries, etc.
What to expect during uterine fibroid embolization
Uterine fibroid embolization usually takes about two hours to complete. The procedure is not painful; however, you will receive a mild sedative through an IV to keep you comfortable, and generally, you will receive a full liquid diet the day of the procedure. During the procedure, you will receive a local anesthetic to numb your groin area, which will be shaved and clean prior to catheter insertion. An interventional radiologist will guide the catheter through the femoral artery using x-ray guidance. Then, contrast will be injected. Once the proper catheter placement is achieved, the radiologist will block the abnormal veins to the fibroids.
After the procedure, you will be admitted to the hospital overnight for observation. Once you have been discharged, there are a few things you should do to ensure proper recovery:
- Drink plenty of clear (nonalcoholic) liquids such as water, juice, or soda once you have returned home – at least 8 oz. every hour.
- Resume your usual diet and any medications you routinely take, unless instructed not to do so by your doctor.
- For the next 12 hours after the procedure, please keep the leg in which the catheter was placed as straight as possible.
- No driving, operating heavy machinery or making any legal decisions for 24 hours following the procedure.
- For several days after, avoid strenuous activities including vigorous exercise, housework, yard work, lifting object heavier than 1 lb. or excessive bending at the waist.
- Do not take a tub bath until incision is healed. This may be several days. You may shower in the meantime.
After your procedure, you will have a follow-up appointment in six months.