Uterine Fibroid Embolisation
- Interventional Radiology
About this procedure
This guide provides information about uterine fibroid embolisation procedure. It includes details about what is involved, how to prepare and what to expect during and after the procedure. Please use this in addition to information from your doctor and nurse.
A uterine fibroid embolisation is performed in an interventional radiology suite at IntraCare in Epsom. Your interventional radiologist will be assisted by our team of nurses and other highly skilled personnel.
Both IntraCare and Allevia Hospital will be involved with your care for this procedure. Allevia Hospital are responsible for your admission, preparation and aftercare.
What is a uterine fibroid?
A uterine fibroid is a benign, abnormal growth that develops in, or on the uterus.
A uterine fibroid embolisation is a procedure in which the main blood supply to the fibroid(s) is blocked. This reduces blood flow to the fibroid(s), and causes them to shrink over time, with improvement of the symptoms you are currently experiencing.
Before the procedure
Pre-procedure phone call
A nurse from IntraCare will call you 24–48 hours prior to your procedure to discuss the following information:
- Your admission time.
- When you should stop eating and drinking.
- Medication instructions.
- Allergies (including medications, contrast dye, dressings/plasters and food).
- Answer any further questions.
Anticoagulation (blood thinner)
If you are taking any blood thinners (e.g. Warfarin, Clexane, Pradaxa, Rivaroxaban), please make this known to IntraCare staff at the time of booking. Your interventional radiologist will advise you if you need to stop this medication temporarily for a few days before the procedure.
Other regular medications
Please continue to take these unless advised otherwise by your interventional radiologist. If you are taking a diuretic or water pills (e.g. frusemide, spironolactone), you may need to withhold this on the morning of the procedure.
Reminders for the day of your procedure
- If you are on regular medication, please bring this with you in its original packaging.
- Please leave all your jewellery and valuables at home. You are welcome to bring your mobile phone in with you.
- We recommend wearing loose-fitting clothing and shoes that are easy to slip on/off.
- You are encouraged to bring a friend or a family member as a support person before and after your procedure.
- This is commonly an overnight stay procedure, please bring an overnight bag with you.
- The planned procedure time is an estimate only and may vary. We will keep you informed of any unexpected delays on the day.
Informed consent
As with any procedure, there are potential risks involved. Your interventional radiologist will explain the procedure, discuss possible risks and answer any questions you may have. Your whānau or support person are welcome to be part of this discussion. You will then be asked to sign the consent form. This will occur either at an earlier appointment or on the day of your procedure.
Your procedure
A uterine fibroid embolisation is performed under conscious sedation and usually takes 60–90 minutes.
Preparation
While you are on Stella Maris ward, Allevia Hospital a small intravenous (IV) line will be inserted into a vein in your arm for intravenous (IV) fluids. You will also be connected to a pain pump, which can be used to help manage your pain during and after the procedure as required. Before the procedure you will be given pre-medication on the ward. We may need to remove hair with clippers at the access site for sterile preparation. Please avoid shaving the area yourself as this may cause minor abrasions to the skin, increasing the risk of infection.
Once you are in the interventional radiology suite you will be given medication to help you relax and other devices for monitoring blood pressure, heart rate and oxygen levels will be fitted to ensure your safety during the procedure.
The procedure
Your doctor will decide whether the left radial (wrist) artery, or right femoral (groin) artery provides the most suitable access site to the fibroid(s). The access area will then be prepared with an antiseptic solution before placing sterile drapes around the access site, and over the rest of your body to ensure sterility is maintained.
You will feel the local anaesthetic injection around the wrist or groin, which will sting for approximately 30 seconds.
A small hollow tube (sheath) will be inserted into the artery at your wrist or groin. Using contrast dye and fluoroscopy, a small catheter is then directed through the sheath into one, or both uterine arteries in the pelvis, which supply the main blood supply to the fibroid(s). Once this catheter is in position, embolisation material is injected to block the blood vessels.
You may feel temporary abdominal or pelvic discomfort when the blood vessels to the fibroid(s) are blocked. This is normal and should be effectively controlled by your pain pump.
The nurse looking after you will monitor your comfort level and support you with the use of the pain pump as required. Should the pain pump not provide sufficient pain relief, please inform the interventional radiologist so alternative pain relief can be given via your IV line.
After your procedure
You will be transferred to Stella Maris ward, where you will recover overnight. If appropriate you will be discharged home the next morning.
If your procedure was performed via the radial (wrist) artery, you will be able to sit up straight away but must remain on bedrest for 4 hours.
If your procedure was performed via the artery in your groin, you will need to lay flat for at least an hour, before slowly sitting up over a period of 4 hours.
Recovery and discharge
- Following your procedure, it is important that you do not drive for 24 hours.
- Please ensure you have a family member or friend to drive you home from the hospital, as you may still be under the effects of anaesthesia or sedation.
- You will need to arrange for someone to be at home with you on the day of your discharge and overnight to support you in your recovery.
- Due to the sedation, you may feel lethargic afterwards with reduced concentration. For this reason, for 24 hours after your procedure:
- Do not do any activity requiring strength, concentration, or full alertness.
- Do not make any legal decisions or sign legal documents.
Resuming activities
- You will be able to return to work within a week of having the procedure unless your job involves heavy lifting (>5kg).
- You can begin light exercise after 1 week.
Medication
Your interventional radiologist will give you a prescription for pain relief (analgesic) to take home. Please use this should you experience any dull aching pain for the following few days.
Radial (wrist) site care
- Keep the site clean and do not rub the wound. Until the site has healed, gently pat it dry after showering.
- If the site looks red, inflamed and/or infected please see your general practitioner (GP).
- You may take paracetamol if your arm is sore. Should your arm continue to be painful, please phone IntraCare on 09 630 1961 (office hours) or 0274 820 763 (after hours).
- Do not lift with the affected arm or do any strenuous activity.
Bleeding
- It is common for there to be a small amount of ooze from the puncture sites. If this occurs, re-apply a sticking plaster and lightly press for a few minutes.
- If there is significant bleeding, you should lie flat, and another person will need to apply firm pressure for 10 minutes. If this does not stop the bleeding, call an ambulance.
Femoral (groin) site care
- Do not do any heavy lifting (>5kg) or strenuous exercise.
- Try not to excessively cough, sneeze, or strain as this puts pressure on the puncture site which may cause it to bleed.
- Do not sit in a bath, hot tub or spa until the skin has healed.
- Do not cross your legs while sitting.
- You may resume walking if your puncture site is not painful.
- Remove the dressing on your groin once the skin has healed (approximately 3 days).
Haematoma
It is common for a haematoma to develop after this procedure. A haematoma is a collection of blood under the skin that is sometimes painful. A small hard lump (similar in size to a pea) may also be felt under the skin and remain for several weeks:
- If a large lump (haematoma) occurs, lie down and get another person to press down firmly on the centre of the haematoma for approximately 10 minutes.
- If after releasing pressure, the haematoma reoccurs, keep applying the pressure and go to your local accident and emergency department.
Bleeding
- It is common for there to be a small amount of ooze. If this occurs, re-apply a sticking plaster and lightly press for a few minutes.
- If there is significant bleeding, you should lie flat, and another person will need to apply firm pressure for 10 minutes. If this does not stop the bleeding, call an ambulance.
Seek immediate medical attention (dial 111 for an ambulance) if there is excessive bleeding from the puncture site or if you are experiencing severe chest pain.
Please show this page and your discharge summary if visiting a GP, after-hours or hospital.
- If you have any concerns, please contact IntraCare:
-
- Monday to Friday (6:30am – 6:00pm): 09 630 1961
- After-hours, weekends, and public holidays: 0274 820 763
In case of emergency, always call 111.
FAQs
Who do I contact if I have concerns following the procedure?
If you have concerns in the first few days, contact your radiologist, or a nurse at IntraCare. Some swelling around the treatment area can be expected, due to the inflammatory process immediately post treatment.
Is this procedure covered by health insurance?
If you have private health insurance please contact our administration team. IntraCare is affiliated with most health insurance providers and will help you with the approval process and will discuss options for self-funding. Please contact the administration team on 09 630 1961.
What are the chemicals of choice for sclerotherapy?
Commonly used sclerosing chemicals at IntraCare are: sodium tetradecyl sulfate (Fibrovein 3%); Bleomycin; absolute alcohol; Doxycycline.
Your interventional radiologist will select the appropriate chemical and concentration of it based on the location and size of the vessel being treated.