Uterine Artery Embolisation

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.