Methodist Hospital - Uterine artery embolization

An emerging treatment option is uterine artery emobolization. This procedure provides a minimally invasive way to block uterine arteries and stop the blood supply to the fibroids. Performed by an interventional radiologist, it involves no surgical incisions, less pain, shorter hospital stays and less recovery time. Studies have not yet been able to confirm its effect on a woman's ability to have children.

This procedure takes one hour to one-and-a-half hours, with an overnight stay. The patient is sedated, but awake throughout the procedure. A needle is used to enter the femoral artery, located at the crease of the leg. A catheter is advanced over the branch of the aorta and into each of the uterine's arteries.

Once the catheters are in place, particles of polyvinyl alcohol (PVA) are injected slowly with X-ray guidance. These particles are about the size of grains of sand. Due to their vascular nature, the particles flow to the fibroids first. The particles wedge in the vessels and cannot travel to any other parts of the body. The embolization continues until the bloodflow is almost completely blocked. When the procedure is finished, an arteriogram confirms procedure's completion. Arterial blood flow still will be present to some extent to the normal portions of the uterus, but not to the fibroids.

Many women who undergo this procedure can resume light activities within a few days and return to normal activities within a week.

This treatment option, while fairly new to patients with uterine fibroids, has been performed for more than 20 years to stop heavy bleeding during childbirth. Studies show that between 78 percent to 94 percent of patients have some relief or total relief from symptoms.

As with any procedure, side effects do exist. They include:

moderate to severe pain and cramping in the first few hours after the procedure
nausea or fever
infection or injury to the uterus (occurs in a very small number of patients)