Uterine Artery Embolisation

Uterine Artery Embolisation (UAE)

Fibroid Disease

Uterine fibroids are non-cancerous growths in the uterus that affect up to 80% of women by age 50. These growths can cause:

  • Heavy or prolonged menstrual bleeding

  • Pelvic pain and pressure

  • Frequent urination

  • Difficulty emptying the bladder

  • Constipation

  • Back or leg pain

  • Fertility problems

Fibroids can vary greatly in size - from as small as a pea to as large as a melon. Their location within the uterus affects symptoms:

  • Submucosal fibroids (inside the uterine cavity) commonly cause heavy bleeding

  • Intramural fibroids (within the uterine wall) can cause pressure symptoms

  • Subserosal fibroids (on the outside of the uterus) typically cause bulk-related symptoms

Adenomyosis

Adenomyosis occurs when the tissue that normally lines the uterus grows into the uterine wall muscle. This condition often coexists with fibroids and can cause:

  • Severe menstrual cramps

  • Heavy menstrual bleeding

  • Enlarged, tender uterus

  • Chronic pelvic pain

UFE has shown promising results for treating adenomyosis symptoms, with over 80% of patients experiencing improvement.

Anatomy

Understanding the blood supply to fibroids is key to UAE treatment. Fibroids receive their blood supply primarily through:

  • Uterine arteries - the main blood vessels feeding the uterus and fibroids

  • Ovarian arteries - backup blood supply that sometimes feeds large fibroids

During UAE, we target these blood vessels to cut off the fibroid's blood supply, causing them to shrink.

Uterine Artery Embolisation Procedure

UAE is a minimally invasive procedure performed by an interventional radiologist. It is also sometimes referred to as uterine fibroid embolisation (UFE):

Before the procedure:

  • You'll receive medications for pain relief and to prevent nausea

  • The procedure is usually done as a day case with overnight admission for observation

During the procedure:

  • A small catheter (thin tube) is inserted through a tiny incision in your groin or wrist

  • Using X-ray guidance, the catheter is guided to the uterine arteries

  • Tiny particles are injected to block blood flow to the fibroids

  • The procedure typically takes 1-2 hours

  • You'll receive pain medication and sedation for comfort

After the procedure:

  • You'll be monitored overnight

  • Pain medication is provided to manage post-procedure discomfort

  • Most patients go home the next day

  • Full recovery typically takes 1-2 weeks

Outcomes

UAE has excellent success rates:

  • 88% of patients report significant improvement in bleeding symptoms

  • 71% experience reduction in bulk-related symptoms

  • Average fibroid shrinkage of 20-60% in size

  • Quality of life improvements are similar to surgery at 5 years

Compared to hysterectomy, UFE offers:

  • Shorter hospital stay

  • Faster return to work

  • Lower blood loss

  • Uterine preservation

  • Similar long-term quality of life

Compared to myomectomy (fibroid removal surgery):

  • Shorter recovery time

  • Lower complication rates

  • Similar symptom improvement

  • Higher chance of needing future treatment (15-20% over 5 years)

Risks and Complications

UAE is generally safe, but like all medical procedures, it carries some risks:

Common side effects (most patients experience):

  • Post-embolisation syndrome: pain, nausea, fatigue, and low-grade fever for 24-48 hours

  • Vaginal discharge for several weeks

  • Irregular periods for a few months

Less common complications (1-5% of patients):

  • Infection requiring antibiotics

  • Passage of fibroid tissue via the vagina

  • Need for additional re-treatment

  • Ovarian dysfunction and early menopause (mainly in women over 45)

Rare complications:

  • Allergic reaction to contrast dye

  • Emergency hysterectomy (<1%)

Important considerations:

  • UAE may affect fertility - discuss with your doctor if you're planning pregnancy

  • Some fibroids may not respond completely to treatment

  • Symptoms may recur over time (15-20% of patients need additional treatment within 5 years)

Summary

UAE is an effective, minimally invasive treatment for symptomatic fibroids and adenomyosis. It offers:

Benefits:

  • Preserves the uterus

  • Minimal downtime compared to surgery

  • High success rates for symptom relief

  • Outpatient procedure

  • No surgical incisions

Best suited for women who:

  • Have symptomatic fibroids causing bleeding symptoms

  • Want to avoid major surgery

  • Wish to preserve their uterus

  • Are not currently planning pregnancy

Not suitable for women who:

  • Are pregnant

  • Have suspected uterine cancer

  • Have active pelvic infection

  • Severe contrast allergy (relative contraindication)

UAE should be discussed as a treatment option for every woman with symptomatic fibroids. Our experienced team at Spectrum Interventional Radiology work closely with referring gynaecologists to provide comprehensive care and help you make the best treatment decision for your individual situation.

For more information or to book a consultation, contact our team.