Uterine artery embolization (UAE) is a medical procedure which is used to selectively block arteries which lead to the uterus. This procedure is performed to control uterine bleeding and to starve uterine fibroids so that they will shrink and eventually resolve. It is performed in a hospital or clinic with the guidance of an x-ray machine. The effects of uterine artery embolization on fertility are not known, so the procedure is generally not recommended for women who would like to get pregnant in the future.
In this procedure, the patient is sedated and connected to monitoring equipment which will continuously monitor her heartbeat, blood pressure, and other vital signs. Next, a catheter is threaded through the groin and into the arteries which supply blood to the uterus, and small beads are carefully injected. These beads block the artery, slowing or preventing blood flow. With fibroids, which tend to be highly vascularized, the beads are attracted to the fibroid, concentrating around its blood supply, and in cases of uterine bleeding, the beads are drawn to the areas of bleeding. This prevents the beads from spreading to areas where they are not desired. Once in place, the beads should not shift.
After the beads are placed, an arteriogram is used to check bloodflow in the area. Then, the catheter is removed and the patient is brought out of sedation. Bed rest for several hours is usually recommended to ensure that the beads have time to settle. Women commonly experience pain and nausea after this procedure, along with cramping, which can last for several days. Most women return to work in one to two weeks after uterine artery embolization.
There are some risks to this minimally invasive procedure. When it is used to treat fibroids, the interruption in blood supply may cause the fibroids to become infected, which can lead to the need to remove the uterus to prevent the infection from spreading, although this is rare. Uterine artery embolization can also lead to infections, scar tissue, interruptions of blood supply to other organs, and adhesions.
Uterine artery embolization is often used to treat fibroids, but it can also be used to manage issues like post-partum hemorrhage, pelvic bleeding caused by trauma, or the growth of tumors in the uterus. Cutting off the blood supply to uterine tumors can cause them to shrink, making UAE an option for cancer treatment which patients may prefer to more invasive surgeries to remove uterine tumors.
