Uterine Fibroid Embolization

Embolization of the uterine arteries is a minimally invasive procedure for treating uterine fibroids and makes it possible to avoid a hysterectomy (removal of the uterus) or multiple myomectomies (myoma, or fibroid, surgery) which results in a weakened uterus.

Uterine embolization involves injecting microparticles into the uterine arteries feeding the fibroids. The aim is to block these arteries, thereby causing necrosis of the fibroids. Preserving our patients’ fertility requires special care by our teams, who use a technique called "fertility sparing embolization".
This procedure is performed by an interventional radiologist under local anesthetic.

Uterine artery embolization makes it possible to treat the symptoms related to uterine fibroids.

Depending on the location, size and number, uterine fibroids may cause symptoms that cause variable amounts of discomfort, such as:

• Heavy menstrual bleeding which can cause anemia,
• Pelvic pain with a feeling of compression in the pelvic area,
• Pain during sex
• Abdominal swelling

Uterine embolization shrinks fibroids and consequently eliminates the symptoms.
 

Uterine embolization is performed in the interventional radiology unit. Our multidisciplinary team, composed of an interventional radiologist, a gynecologist and a fertility specialist, ensure that uterine fibroids are treated in a safe environment.

• The day of the procedure, you will be taken to the interventional radiology room.
• Although it is not painful, navigating the arteries is performed under local anesthetic. For maximum comfort and safety, an anesthesiologist and a nurse will be with you throughout the procedure, which lasts one hour.
• You won’t have a scar after the procedure. You will be able to walk immediately if the catheter was inserted through your wrist, or after four hours if it was inserted through your groin..
• Ischemia* of fibroids induced by embolization will cause pain for two to three days after the procedure.

The interventional radiology unit at the American Hospital of Paris is one of the few teams in France to manage post-embolization pain using an analgesic. The technique is performed by the anesthesiologist, who administers a single dose of morphine via spinal epidural, without inserting a catheter. This allows the patient to be pain-free for 12 to 20 hours.

Recovery time at home is three to four days after embolization, much shorter than after surgery.

*Fibroid ischemia is the blockage of the blood supply to the fibroid, depriving the cells of oxygen and leading to necrosis of the fibroids.

You need to fast (nothing to eat or drink) starting at midnight before the procedure. During the pre-anesthesia consultation, advise your physician of any current medications or treatments. The day of the procedure, take your medications as usual, as directed by the anesthesiologist, with a small sip of water. You will also need to bring all your x-rays and biological tests related to your uterine fibroid.

Uterine embolization at the American Hospital of Paris is performed either on an outpatient basis or in the hospital for one night for monitoring and pain management.

You can resume your normal activities after three days.

Uterine fibroid embolization significantly relieves the symptoms related to uterine fibroids (heavy bleeding, pelvic pain, abdominal swelling) over the three months following the treatment.

In most women, these results seem to be comparable to those of a myomectomy (surgical treatment of the uterine fibroids by ablation).

Studies have shown a significant rate of improvement‒in the range of 78% to 94% ‒ or even the total disappearance of pain and other symptoms. While it is entirely possible to become pregnant after the procedure, the impact of uterine embolization on fertility and pregnancy remains a subject of discussion. Because of this uncertainty, the decision to undergo this treatment will always be made in coordination with the fertility center.

The risk of recurrence is low.
 

The risk of significant complications following uterine embolization is very low and comparable to that of surgical treatment of fibroids.

These complications may include:

- Uterine infection caused by fibroid degeneration, which could promote bacterial growth in the uterus. In such case, we prescribe antibiotic treatment. In extreme cases, the infection could require a hysterectomy (uterine ablation).

- Involuntary embolization of another organ could occur. In very rare instances, uterine embolization results in a lack of blood supply to the ovaries, which can cause premature menopause. Note that, to date, the American Hospital’s team has not reported any cases of embolization of an adjacent organ.

- The ovaries resume their normal function two to six months after the procedure, and menstrual periods are re-established. The risk of sterility due to uterine fibroid embolization is declining since the use of calibrated microparticles.

Nevertheless, if you wish to have children, we advise you to discuss with your physician the risks of this procedure on your fertility and future pregnancy.

In accordance with Article 53 of the code of ethics, physician fees are determined with tact and moderation, and compare with the national average.
You will benefit from medical expertise, the safety of a regular hospital, exclusive care by the anesthesiology team and paramedical staff, as well as a pleasant and comfortable setting.