Fletcher Allen, a Vermont university hospital and medical center, serves all of
Vermont and the northern New York region. Located in Burlington, Fletcher Allen is a regional, academic healthcare center and teaching hospital in alliance with the University of Vermont.
Uterine Fibroid EmbolizationUterine fibroids are benign tumors which can cause excessive menstrual bleeding and pain. These tumors grow slowly but may become large enough to compress the bladder and rectum causing constipation and/or urinary frequency.
Traditional treatment has been hysterectomy however patients have the option of a less invasive procedure called: “Uterine fibroid embolization.”
Under x-ray observation, particles are injected until blood flow in the uterine arteries is blocked. In most cases, both uterine arteries can be treated through a single catheter insertion. By blocking blood flow to the fibroids, uterine fibroid embolization in effect "starves" them of the blood they need to grow. When deprived of blood, the tumor masses die, and then develop into scar tissue and shrink in size. The symptoms they previously caused become less bothersome or disappear altogether. Multiple fibroids may be treated at the same session by uterine fibroid embolization, and even very large ones can be effectively treated by this procedure.
How do I prepare for the procedure?
You will be scheduled for a consultation with the Interventional Radiology Team. Bring a list of questions to ask your doctor. It is important that you understand exactly what procedure is planned, the risks, benefits and other options before your procedure.
What happens during the procedure?
Conscious sedation is provided just prior to starting the procedure. You will be connected to several types of monitoring equipment. You will be lying on the x-ray table. The technologist will prepare the skin over the groin by cleaning it with an antiseptic solution and place sterile drapes and towels over you to create a sterile work space. Lidocaine® local anesthesia is injected into the skin overlying your groin. A catheter is placed into the artery and contrast dye is injected to allow visualization of the arteries that supply the uterus. Small inert particles are injected into these arteries until the blood flow to the uterus has stopped. These particles are mixed with x-ray dye so that the radiologist can be assured that they are going only to the uterus and not elsewhere. The catheter is removed and pressure is applied to the groin until there is no bleeding (approximately 15min). This procedure takes approximately 1.5 - 2 hours.
What happens after the procedure?
The actual procedure itself is not particularly painful however the crampy pain that follows can be quite uncomfortable. For this reason patients are admitted to the hospital overnight for pain control and IV fluid hydration. You will have a PCA (Patient Controlled Anesthesia) pump connected to an IV line. This will allow you to self administer pain medication by clicking a button.
Some patients develop nausea which can be treated with medication and IV fluids. Most patients are able to go home the next morning with a prescription for pain medication. The crampy pain should gradually subside over the next several days. It usually takes two to three months for the fibroids to shrink enough so that bulk-related symptoms such as pain and pressure improve. It is common for heavy bleeding to improve during the first menstrual cycle following the procedure. Patients can expect to see gradual improvement in bleeding symptoms with more than 90% of patients having complete resolution or marked improvement by 6 months. Bulk symptoms have a success rate of 50-60%.
While low grade fever (101.1°F) is common following fibroid embolization, you should contact your physician if you experience progressively increasing pain, spiking fevers and/or shaking chills.
Patients can expect a follow-up pelvic ultrasound at 6 months to assess response to therapy.It is important to note your OB/GYN remains the primary caregiver for your reproductive health.