Uterine artery emoblization (UAE) - uterine fibroid embolization (UFE) is a new minimally invasive therapy for treatment of uterine fibroids. It is a safe alternative to hysterectomy for treatment of symptoms caused by uterine fibroids that has been shown to be effective in 90% of patients suffering from problems caused by uterine fibroids.

About Uterine Artery Embolization (UAE) - Uterine Fibroid Embolization (UFE)

Uterine fibroids are the most common tumor of the female reproductive tract. Over 150,000 hysterectomies are performed annually for symptomatic fibroids. These tumors occur in 20-40% of women over the age of 35 with the higher range of incidence being among African-American women. Up to 20% of women with fibroids have significant symptoms. These symptoms include: heavy bleeding, anemia, pelvic pain, pressure sensations, urinary frequency, constipation, infertility and sciatica caused by sacral plexus compression. Menopause will usually result in regression of the fibroids and their symptoms although only if hormonal replacement therapy is not used. Hysterectomy is curative albeit with attendant problems and morbidity related to a major surgical procedure. Several days of hospitalization are required and convalescence is usually six weeks or more. There is also the issue of long-term effects of hysterectomy and its effect on the integrity of the pelvic floor with a significant incidence of stress incontinence (40% higher in one clinical series). Gonadotropin releasing hormone agonists (Lupron)  have been advocated and are effective in reducing the size of uterine fibroids, but only temporarily. These agents produce rapid onset of menopausal symptoms without the option of hormone replacement therapy for palliation of symptoms. Osteoporosis is accelerated by this therapy. Myomectomy is an option that preserves the uterus and fertility, but is also a major surgical procedure with significant morbidity and risk of significant blood loss during the procedure. The latest therapy for uterine fibroids - Uterine Fibroid Embolization (UFE) - was developed as a result of trying to reduce blood loss during myomectomy.  There is also a high risk of recurrence of the symptoms as there are usually multiple tumors and this procedure is only effective if the correct ones are removed.

While uterine artery embolization has been used for a variety of indications including post partum hemorrhage and bleeding tumors for over twenty years, the initial experience with uterine fibroid embolization was reported by Jacques Ravina, at the Laraboisiere Hospital in Paris, France in 1995. His results were published in the medical journal Lancet. This initial small series was based on a group of patients who had preoperative embolization before surgical myomectomy and, for various reasons ended up not having the myomectomy. Almost all of these patients were serendipitously found to have complete relief of their symptoms without the surgical procedure. Subsequent larger series confirmed his results leading ultimately to the adoption of this procedure in the U.S. and other countries. The first series reported in this country was out of UCLA in 1997, reported in the Journal of Vascular and Interventional Radiology by Scott Goodwin. Since that time, thousands of uterine fibroid embolizations have been successfully performed across the U.S. with most reported series indicating an 85-90% clinical success with a low complication rate and low morbidity.

Even though UFE is a minimally invasive procedure, it is not without risk. Post procedure pain can be significant. Post infarction syndrome is treated with non-steroidal anti-inflamatory drugs (NSAIDS), narcotics, anti-emetics and acetaminophen. Amenorrhea develops post procedure in approximately 2% of patients under 45 and 15% of patients over 45. Hysterectomies for complications including endometritis and uterine infarction are rare, reported in less than 0.7% of patients. There have been four deaths reported in the world literature out of many thousands of procedures.

At Wake Radiology Interventional Services we first see you in our outpatient clinic located in our Cary office.  There you will have a brief exam and your history will be reviewed.  The procedure, the options and the risks and complications will be discussed in detail.  If you wish to proceed, we will schedule "imaging studies" of your pelvis which typically include MRI or ultrasound.

To schedule or discuss uterine artery embolization (UAE) - uterine fibroid embolization (UFE), please call us at our office at (919) 854-2180.

Note: We do not perform pelvic exams in our office.  We ask that you have had a pelvic exam within three months before this procedure including a pap-test cancer screening procedure.  If you do not have a Gynecologist, we will be happy to assist you in locating one.