Uterine artery embolization – wikipedia endometrial biopsy results time frame

Uterine artery embolization is used to treat bothersome bulk-related symptoms or abnormal or heavy uterine bleeding due to uterine fibroids or for the treatment of adenomyosis. Fibroid size, number, and location are three potential predictors of successful UFE. [3] [4] [5]

Long term outcomes with respect to how happy people are with the procedure are similar to that of surgery. [6] There is tentative evidence that traditional surgery may result in better fertility. [6] UAE also appears to require more repeat procedures than if surgery was done initially. [6]

The rate of serious adverse effects is comparable to that of myomectomy or hysterectomy. The advantage of somewhat faster recovery time is offset by a higher rate of minor complications and an increased likelihood of requiring surgical intervention within two to five years of the initial procedure. [7]

• Post-embolization syndrome (PES) – characterized by acute and/or chronic pain, temperatures of up to 38.8 °C or 101.8 °F, malaise, nausea, vomiting and severe night sweats; foul vaginal odor coming from infected, necrotic tissue which remains inside the uterus; hysterectomy due to infection, pain or failure of embolization [15]

• Hematoma, blood clot at the incision site; vaginal discharge containing pus and blood, bleeding from incision site, bleeding from vagina, fibroid expulsion (fibroids pushing out through the vagina), unsuccessful fibroid expulsion (fibroids trapped in the cervix causing infection and requiring surgical removal), life-threatening allergic reaction to the contrast material, and uterine adhesions [ citation needed]

The procedure is performed by a Vascular Interventional Radiologist under moderate sedation. Access is commonly through the radial or femoral artery via the wrist or groin, respectively. After anesthetizing the skin over the artery of choice, the artery is accessed by a needle puncture. An access sheath and guidewire are then introduced into the artery. In order to select the uterine vessels for subsequent embolization, a guiding catheter is commonly used and placed into the uterine artery under x-ray fluoroscopy guidance. Once at the level of the uterine artery an angiogram with contrast is performed to confirm placement of the catheter and the embolizing agent (spheres or beads) is released.Blood flow to the fibroid will slow significantly or cease altogether, causing the fibroid to shrink. This process can be repeated for as many arteries as are supplying the fibroid. This is done bilaterally from the initial puncture site as unilateral uterine artery embolizations have a high risk of failure. With both uterine arteries occluded, abundant collateral circulation prevents the uterus from necrosing and the fibroids decrease in size and vascularity as they receive the bulk of the embolization material. The procedure can be performed in a hospital, surgical center or office setting and commonly take no longer than an hour to perform. Post-procedurally if access was gained via a femoral artery puncture an occlusion device can be used to hasten healing of the puncture site and the patient is asked to remain with the leg extended for several hours but many patients are discharged the same day with some remaining in the hospital for a single day admission for pain control and observation. If access was gained via the radial artery the patient will be able to get off of the table and walk out immediately following their procedure. The procedure is not a surgical intervention, and allows the uterus to be kept in place avoiding many of the associated surgical complications. References [ edit ]