Interventional radiologists use uterine fibroid embolization as a treatment for symptomatic uterine fibroids. By occluding flow in the right and left uterine arteries, the fibroids are effectively deprived of their blood supply. This leads to necrosis, degeneration and eventual death of the fibroid. As the fibroids undergo this process, they shrink in size, leading to a dramatic decrease in abnormal uterine bleeding and bulk-related symptoms such as pelvic cramping, abdominal distention and bladder compression.
Embolization of fibroids is generally well tolerated by patients and has the advantages of being able to treat all fibroids in one session and a shorter hospitalization. Uterine fibroid embolization is performed with an angiogram. Potential complications of embolization of the uterine arteries include pelvic infection, inadvertent embolization of normal structures and premature menopause.
During the procedure, which takes one to two hours, you may get medicine through an IV (intravenous) line to relax you. You'll also be given an injection to numb the insertion site.
Before your embolization, you may be requested to come to the hospital to meet the radiologist who will perform your procedure and to have blood work done.
Wear comfortable clothes the day of the procedure. Leave money, jewelry and valuables at home. You may bring slippers, a robe and reading material.
Do not eat any solid food after midnight the night before the procedure. You may have a clear liquid breakfast the day of the procedure. Clear liquids include water, apple juice, clear soda, tea, chicken broth and Jell-O. If you are diabetic and taking insulin; take half your normal morning dose of insulin and one glass of orange juice. You may also have the above listed clear liquids. You may be asked to take Ibuprofen 800mg. (four 200mg. tablets) three times a day for 48 hours prior to your procedure.
Take all your routine morning medications the day of the procedure, unless instructed by the doctor or nurse to hold special medications. Medications such as aspirin or blood thinners may be stopped prior to angiography. Bring all your current medications in their original containers to the hospital the day of the test.
After the procedure, you are taken to your room to rest for five to six hours. A nurse will monitor your blood pressure and pulse. You will be able to eat at this time. The immediate response to the procedure has been variable, so you will stay in the hospital overnight. You will be given a PCA pump that allows you to self administer pain medication.
Pain occurs after the procedure in response to tissue death from lack of blood supply. Pain will subside as the tissue changes. You will be provided with adequate pain medication upon discharge. Fever is related to tissue breakdown and is not indicative of infection. As vaginal bleeding stops, a brownish-gray vaginal discharge may occur. This is due to elimination of the degenerating fibroid.
When you are discharged home, you will have a small bandage over the catheter insertion site. You can remove it in one or two days.
On the day you go home, you should not drive or exercise. You should avoid bending and lifting.
Normal activities may be resumed usually within one to two weeks. Heavy lifting is avoided for two weeks or longer, depending on the ease with which you resume activities.
You will be contacted by the radiology nurse after discharge to check on your progress. Please call your referral doctor for follow-up after your next menstrual cycle.
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