Uterine Fibroids and Hysterectomy - Medications

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Recurrence of Fibroids. Myomectomy is not necessarily a permanent solution for fibroids. They can recur after these procedures.

Uterine Artery Embolization

Uterine artery embolization (UAE), also called uterine fibroid embolization (UFE), is a relatively new way of treating fibroids. UAE deprives fibroids of their blood supply, causing them to shrink. UAE is a minimally invasive radiology treatment and is technically a nonsurgical therapy. It is much less invasive than hysterectomy and myomectomy, and involves a shorter recovery time than the other procedures. The patient remains conscious, although sedated, during the procedure, which takes around 60 - 90 minutes.

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The procedure is typically performed in the following manner:

• The patient receives a sedative to cause drowsiness, and a local anesthetic is applied to the skin around the groin.
• An interventional radiologist makes a small quarter-inch incision in the skin and inserts a catheter (a thin tube) into the femoral artery. The femoral artery is a large artery that begins in the lower abdomen and extends down to the thigh. The radiologist then threads the catheter into the uterine artery.
• Small plastic particles are injected into the artery. These particles block the blood supply to the tiny arteries that feed fibroid cells, and the tissue eventually dies.
• Patients usually stay in the hospital overnight after UAE and are given pain medication. Pelvic cramps are common for the first 24 hours after the procedure.
• It takes 1 - 2 weeks for the patient to recover from the procedure and return to work. It may take several months to several years for the fibroids to completely shrink.
• Most patients have a light, brownish color vaginal discharge for several days following UAE, which may last until the next menstrual cycle. Most women resume regular menstrual cycles within 2 – 3 months of the procedure.Heavy menstrual bleeding reduced by the second or third cycle.

Effect on Fertility. In general, UAE is considered an option for only those who have completed childbearing. The American College of Obstetricians and Gynecologists advises women who wish to have children that it is not yet known how this procedure affects their potential for becoming pregnant. Some evidence indicates UAE may increase the risk for miscarriage in women who do become pregnant.