Uterine Fibroids and Hysterectomy - Medications

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Complications. UAE has a lower rate of complication than hysterectomy and laparotic myomectomy and a shorter hospital stay. Compared to other procedures, women who have UAE miss fewer days of work. Serious complications occur in fewer than 0.5% of cases. In addition to potential impact on fertility, other postoperative effects may include.

• Pain. Abdominal cramps and pelvic pain after the procedure are nearly universal and may be intense. Pain usually begins soon after the procedure and typically plateaus by 6 hours. On-demand painkillers may be required. The pain usually improves each day over the next several days. A low-grade fever and general malaise are also common in the first week after the procedure.
• Early menopause. Most women who have UAE will continue to have normal menstrual periods. Some women, however, go through menopause after the procedure. Menopause is more likely to occur in women over age 45 who have UAE.

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Success Rates. Studies on uterine artery embolization show high patient satisfaction (over 90%) and low complication rates. Menorrhagia symptoms, as well as pelvic pain and urinary symptoms, improve in 85 – 95% of patients within 3 months after treatment. Uterine artery embolization is effective for a large majority of patients. However, some women may have fibroid recurrence and may need future procedures (repeat embolization or hysterectomy).

Some studies suggest that women with larger single fibroids or larger uteruses are not good candidates for UAE.

Endometrial Ablation

Endometrial ablation destroys the lining of the uterus (the endometrium) and is usually performed to stop heavy menstrual bleeding. It may also be used to treat women with small fibroids. It is not helpful for large fibroids or for fibroids that have grown outside of the interior uterine lining. For most women, this procedure stops the monthly menstrual flow. In some women, menstrual flow is not stopped but is significantly reduced.

Endometrial ablation procedures use some form of heat (radiofrequency, heated fluid, microwave) to destroy the uterine lining. The procedure is typically done on an outpatient basis and can take as few as 10 minutes to perform. Recovery generally takes a few days, although watery or bloody discharge can last for several weeks.