Uterine Artery Embolization — a new technique for fibroid management with no cut and suture.
Uterine fibroids common pathology of female uterus. It is mostly benign pathology with can interfere with fertility of the women. Fibroids can cause variable symptoms. They may be totally without symptoms or can present with common symptoms like pelvic heaviness, abnormal periods with increased bleeding or abnormal menstural cycles.
Surgical treatment of the fibroids have been done in the past .It works by removing the uterus or fibroid. However it is not feasible for younger age groups where fertility is required.
New treatments have come to the picture. These include uterine artery embolization. It is the least non-surgical technique for treatment of symptomatic fibroids .
Embolization is done by specialists called interventional radiologist .It is performed by blocking abnormal blood supply of the fibroids .This leads to correction of abnormal bleeding associated with fibroids and shrinkage of fibroids over a period of time.
This procedure is becoming more popular due to its efficacy and shorter recovery time .It also helps in saving the uterus for future pregnancy.
Uterine Artery Embolization
UAE is procedure that selectively cannulates the uterine arteries that supply blood to fibroids. The procedure involves multiple steps:
- Patient Preparation
The patient generally remains awake or mild sedation is given
Access is developed for the femoral artery using a sheath.
2. Catheter cannulation and Embolization
Under fluoroscopic guidance, the catheter are moved into the uterine arteries.
Tiny embolic particles are injected into the arteries supplying the fibroids.
These particles block blood flow causing fibroid shrinkage over time.
3. Completion and Recovery
The catheter is removed after the completion of the procedure and entry point is closed. There is minimal discomfort to the patient .
Patients stay in the hospital for observation for a few hours or overnight and recovery is faster than surgical methods.
Benefits of Uterine Artery Embolization
UAE is preferred alternative to surgery due to several advantages:
It is minimally Invasive and no major surgical cuts are required .It reduces the risk of complications and infection.
Unlike hysterectomy, UAE allows women to retain their uterus, which helps to preserve the future pregnancy.
It has shorter Recovery time and patients can resume normal activities within few days.
It provides effective symptom relief in uterine bleeding ,pain and pressure effects.
It carries lower risk of complications no risks risks associated with general anesthesia and major surgery.
Risks and Potential Complications
While UAE is generally safe, there are potential risks, including:
Post-Embolization Syndrome:
It includes symptoms like mild fever, pelvic pain, and nausea due to fibroid shrinkage and degeneration. It can be managed with painkillers and resolves within a few days.
Incomplete Fibroid Shrinkage:
Some fibroids may not respond completely and may require additional treatment or repeat embolization.
Impact on Fertility:
Embolization can cause early menopause but its benefits in improving fertility are much more than limitations.
Rare Complications:
These include infection, uterine necrosis (damage to uterine tissue), or non-target embolization (where embolic material affects unintended areas).
Who should go for UAE?
UAE is suitable for women who:
Have symptomatic fibroids causing heavy bleeding, pain, or pressure symptoms.
Seek an alternative to surgery with a faster recovery.
Want to preserve their uterus .
Are not candidates for myomectomy due to multiple or large fibroids.
However, UAE may not be suitable for:
Women planning future pregnancies as it reduces pregnancy enhances to some extent.
Patients with very large fibroids .
Women with submucosal fibroids (which distort the uterine cavity and may be better treated with hysteroscopic myomectomy
UAE and Fertility Considerations
While UAE preserves the uterus are not straight forward. It helps to improve pregnancy by reducing the size of the fibroids , which are associated with miscarriage or placental abnormalities. However reducing flow to uterus can reduce the chance of pregnancy. Careful evaluation is required.
Conclusion
Uterine artery embolization is a new technique which is minimally invasive treatment for uterine fibroids. It helps in effective symptom relief with fewer complications and a shorter recovery time compared to traditional surgery.
UAE provides an important option for women seeking an alternative to hysterectomy . However UAE is emerging as primary treatment for the fibroid management in many set of patients.
