Uterine Artery Embolization Care

Risk Factors

Factors affecting UAE candidacy:

• Fibroid location and proximity to endometrium
• Desire for uterine preservation
• Contraindication to surgery or anesthesia
• Prior failed medical or surgical treatment
• Presence of adenomyosis in addition to fibroids

Who is at Risk

Women with symptomatic uterine fibroids who wish to avoid surgery, those with multiple fibroids not suitable for myomectomy, and women not planning future pregnancy are ideal candidates for UAE.

Diagnosis

Pre-procedure workup includes:

• Pelvic MRI for fibroid mapping and vascular anatomy
• Pelvic ultrasound for baseline fibroid assessment
• Blood tests including CBC and renal function
• Endometrial biopsy to rule out malignancy
• Gynecological examination and consultation

Treatment Options

UAE is performed under local anesthesia with sedation by an interventional radiologist. Microspheres or gelfoam particles are injected into the uterine arteries via femoral artery access, blocking blood supply to fibroids. The procedure takes 1 to 2 hours.

The Procedure

The UAE procedure involves:

• Patient positioned on fluoroscopy table under sedation
• Femoral artery puncture and catheter insertion under image guidance
• Selective catheterization of bilateral uterine arteries
• Angiogram to map the uterine blood supply
• Injection of embolic microspheres to block fibroid blood flow
• Confirmation of complete embolization on final angiogram
• Catheter removal and groin compression with post-procedure monitoring

After the Surgery

Post-procedure care includes:

• Hospital stay of 1 night for pain management
• Post-embolization syndrome managed with anti-inflammatory medications
• Gradual reduction in fibroid size over 3 to 6 months
• Follow-up MRI at 3 months to assess fibroid shrinkage
• Return to normal activities within 7 to 10 days
• Menstrual pattern improvement noted by second cycle

Possible Complications of UAE

Potential complications include:

• Post-embolization syndrome with fever, pain, and nausea
• Non-target embolization affecting ovarian blood supply
• Risk of premature ovarian failure in women over 40
• Fibroid expulsion requiring gynecological intervention
• Uterine or endometrial infection in rare cases
• Recurrence of fibroid symptoms over time