What are the indications?
Uterine fibroids (sometimes referred to as leiomyomas) are the most common tumors of the female genital tract. They are noncancerous and do not always cause symptoms. However, in some women, their size and location can lead to problems, like pain and heavy bleeding as well as pressure on urinary bladder or bowel.
Embolization is an excellent alternative to surgical removal of fibroids or the whole uterus; blockage of the arteries supplying the uterus lead to the shrinkage of the fibroid and 90% of women experience relief of the symptoms.
Before the intervention you will need ultrasound and MRI evaluation of your uterus, which will confirm that the fibroids are the cause of your problems.
The procedure is similar to general angiography and embolization.
The radiologist will, with a help of X-rays, place the tiny tube (micro catheter) into the artery supplying the blood to the fibroids and inject contrast to outline them;
The preferred agents for occlusion of the bleeding artery are polyvinyl alcohol particles or embospheres, which will slowly flow into the uterus and nearly completely occlude selected artery. As the uterus is supplied by both right and left uterine arteries, the procedure will be repeated on the other side.
Is there any additional risk?
The possibility that the embolization agent can dislodge into the arterial system and deprive healthy tissue of blood supply is minimal. It is avoided by the careful positioning of the micro catheter supraselectively into the uterine artery.
Sometimes, the anatomy of the bleeding artery and its branches may be too complex for the safe placement of tube. In that case the radiologist will advice you that the procedure is not technically feasible and your attending doctor will present you with the other (possibly surgical) treatment options.
Some patients complain of cramping and pain in the pelvis over the next 24-48 hours after the procedure, which will necessitate administration of painkillers.
It is not uncommon to experience flu-like symptoms (post embolization syndrome) for 5-7 days after the procedure. Mild fever, nausea, aching and pain are usually managed easily with medication.
The other risks are similar to general angiography and embolization
Can I become pregnant after the procedure?
Normal pregnancies and births have been reported after the embolization. However not enough research has been done to confirm that pregnancy won’t be affected by the procedure. Therefore, most physician recommend against future pregnancies after the embolization procedure.