Uterine Artery Embolization
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- Uterine Artery Embolization
Uterine Artery Embolization (UAE), also called Uterine Fibroid Embolization (UFE) when performed for fibroids, is a minimally invasive procedure performed by an interventional radiologist to treat uterine fibroids by blocking their blood supply. The fibroids shrink over time, leading to improvement in symptoms.
What are fibroids?
Fibroids (also called uterine leiomyomas) are non-cancerous growths arising from the muscle layer of the uterus.
Uterine Fibroids
Common symptoms:
- Heavy menstrual bleeding
- Prolonged periods
- Pelvic pressure or pain
- Frequent urination
- Constipation
- Enlarged abdomen
- Pain during intercourse
- Infertility in some cases
TYPES OF UTERINE FIBROIDS:
- Intramural Fibroids- Located within the uterine wall.
- Submucosal Fibroids- Project into the uterine cavity.
- Sub-serosal Fibroids- Project outward from the uterus.
- Multiple Fibroids- UAE is particularly useful when numerous fibroids are present.
How UAE Works?
Fibroids receive blood mainly from the uterine arteries.
During UAE:
- A small catheter is inserted into an artery (usually at the wrist or groin).
- The catheter is guided to both uterine arteries using X-ray imaging.
- Tiny particles are injected.
- These particles block blood flow to the fibroids.
- The fibroids lose their blood supply and gradually shrink.
–The normal uterus usually continues to receive blood from other vessels and remains viable.
INDICATIONS:
-UAE may be recommended for women with/ Suitable candidates:
- Symptomatic fibroids
- Heavy menstrual bleeding
- Pelvic pressure
- Bulk-related symptoms
- Fibroid-related anemia
- Multiple fibroids
- Recurrence after previous surgery
- Patients wishing to avoid hysterectomy
Who May Not Be Suitable?
UAE may not be appropriate in:
- Pregnancy
- Active pelvic infection
- Suspected uterine cancer
- Severe contrast allergy
- Severe kidney dysfunction
- Some women actively planning future pregnancy (requires individualized discussion)
PRE- PROCEDURE EVALUATION
Medical History
Assessment of:
- Symptoms
- Previous surgeries
- Fertility goals
- Medications
- Allergies
Blood Tests
Complete blood count
* Kidney function tests
* Coagulation profile
Imaging
Pelvic MRI (Most commonly)
MRI helps determine:
- Fibroid size
- Number
- Location
- Blood supply
- Alternative diagnoses
Ultrasound may also be used
Step-by-Step Procedure
1. Admission- Usually a day-care or overnight stay.
2. Anesthesia
Most commonly:
- Conscious sedation
- Pain medications
- Local anesthesia
General anesthesia is usually not required.
3. Arterial Access
Either:
- Radial artery (wrist)
- Femoral artery (groin)
4. Angiography:
Contrast dye is injected to visualize: Uterine Artery
5. Embolization-
Tiny particles are injected until blood flow significantly slows or stops.
Common embolic materials:
- Polyvinyl alcohol particles
- Microspheres
6. Completion Angiogram-
A final angiogram confirms successful blockage of fibroid blood supply.
7. Recovery-
The catheter is removed and pressure is applied.
What Does Angiography Show?
Before Embolization | After Embolization |
Enlarged uterine arteries | Markedly reduced blood flow |
Hyper-vascular fibroids | |
Tumour blush appearance | Disappearance of fibroid blush |
Benefits of UAE
- Uterus Preservation-No need to remove the uterus.
- Uterine Size Reduction-The uterus also becomes smaller over time.
- Minimally Invasive-It requires no major abdominal incision, involves lower complication rates, and generally allows for a faster recovery time
- Short/Faster Recovery- Most patients can go home on the same day. Usually 1–2 weeks can continue daily routine activities.
- Bleeding Improvement-Often improves within the first few menstrual cycles.
- Fibroid Shrinkage-Fibroids typically shrink over several months.
- Effective Symptom Relief
-Many women experience:
- Reduced bleeding
- Reduced pelvic pressure
- Improved quality of life
-Multiple Fibroids Treated Simultaneously
Unlike surgery that may remove selected fibroids, UAE treats all fibroids supplied by the uterine arteries.
Possible Complications:
-Although uncommon, complications can occur.
A. Minor Complications
- Bruising at access site
- Temporary pain
- Nausea
- Fever
B. Major Complications
- Infection
- Severe bleeding
- Uterine injury
- Premature ovarian failure
- Need for emergency hysterectomy (rare)
Comparison with other alternative surgical procedures:
UAE vs Myomectomy
Features | UAE | Myomectomy |
Incision | Tiny puncture | Surgical |
Uterus preserved | Yes | Yes |
Recovery | Faster | Slower |
Multiiple fibroids | Excellent | More difficult |
Future fertility | Less predictable | Usually preferred |
Hospital stay | Short | Longer |
UAE vs Hysterectomy
Features | UAE | Hysterectomy |
Uterus remains | Yes | No |
Pregnancy possible | Potentially | No |
Major surgery | No | Yes |
Recovery | Faster | Slower |
Would you like to request an appointment?
You can call on +91-98200 86520 for Appointments or fill the form below