UFE

What is uterine fibroid embolization?

Uterine artery embolization (UFE) is a non-surgical treatment for uterine fibroids. Fibroids are non-cancerous tumors that may cause heavy menstrual cycles, pelvic pain, and pressure to other internal organs. UFE is performed through an artery in the groin. The interventional radiologist threads a very fine tube into the artery that supplies blood to the fibroid and injects particles into the artery to block the flow. Once the blood supply is blocked, the fibroid is deprived of oxygen and shrinks in size.

How do I prepare for the procedure?

Do not eat or drink anything past midnight the evening prior to your procedure. You will receive instructions that include your time of arrival to St. Vincent Medical Center. After your registration, you will be taken to a room for pre-procedure preparation. Here, one of our staff will start an IV, take your vital signs, verify your consent for the procedure and answer questions related to the proceeding. Prior to your study, you will be given a sedative to help you relax and manage your pain, but you will be conscious during the embolization.  

Our interventional radiologist will place a small tube into an artery in your groin and take a series of images that will identify the artery feeding the fibroid. Embolization particles are then injected into the artery branches. Once the particles are in place, the tube is removed. Once the procedure is over, you will remain overnight in the hospital. During your stay, the staff will manage your pain, administer antibiotics, and continue IV fluids. Barring any complications, you will be discharged from St. Vincent the morning after the procedure. Most women experience mild to moderate cramps the first several days but are able to return to their normal activities in a week. Prior to your discharge, you will receive detailed instructions. It is important to read and follow these closely. Excessive pain, and /or fever are not normal and need to be addressed immediately.

How does it work?

Your uterus is an organ with many blood supplies. When a fibroid grows in the uterus, it is fed by one or many blood supplies. By blocking the supply with injected particles it starves the fibroid, causing it to eventually shrink.

What complications could I experience?

Most patients experience some pelvic pain and cramping, most of which can be managed with oral pain medications. Occasionally, women experience nausea. It is not uncommon to experience spotting for the first month after the embolization. Serious complications related to UFE are rare. Less than 1 % of those women having the procedure experience serious complications.

Will this procedure help me?

Statistically, 80-85 percent of the women who undergo UFE have a reduction in their fibroid symptoms.

Hysterosonography

What is hysterosonography?

Hysterosonography, also know as sonohysterography or saline infusion sonography, is an ultrasound scan of the uterus. The procedure is a minimally invasive technique that provides real-time images of your internal organs and blood flow to the uterus. This procedure is often used to investigate uterine abnormalities in women who experience multiple miscarriages or are infertile.

Hysterosonography is a valuable technique for evaluating unexplained vaginal bleeding that may include:

• Congenital defects
• Masses
• Adhesions or scarring
• Polyps
• Fibroid tumors
• Uterine atrophy

Doppler scanning or ultrasound that measures blood flow during the procedure is helpful when evaluating:

• Blockages to blood flow, such as a clot
• Plaque formation in the uterine vessels
• Tumors and congenital abnormalities

How should I prepare for this procedure?

Hysterosonography is best performed one week after your last menstrual cycle. This cyclic phase is when the endometrium or uterine lining is thinnest and most likely in its normal state. This procedure should not be performed if you are pregnant. There is no special preparation prior to the exam, but some patients may be advised to take an over-the-counter pain reliever shortly before the procedure to minimize any potential procedural discomfort.

What should I expect?

Hysterosonography is performed with the installation of sterile saline into the uterus through a catheter. The fluid distends the uterus and outlines anatomy and abnormalities. The ultrasound procedure is performed vaginally, much like a gynecological exam. The initial phase of the exam is done prior to the catheter insertion. Once images are taken, the radiologist will insert the catheter into the uterine cavity and the ultrasound transducer is reintroduced. Saline is then injected via the catheter while being viewed by the ultrasound probe. The examination is usually completed in 30 minutes. During the hysterosonogram there may be occasional cramping, often the result of saline introduction. A vaginal sonogram is generally more comfortable than having a gynecological exam. After the examination is completed, you should be able to resume your normal activities.

How can I get the results?

After your study is complete, the images will be evaluated by one of our women’s imaging specialists. A final report will then be sent to your physician who can discuss the results with you in detail.

What is a pelvic MRI?

A pelvic MRI is a magnetic resonance study of the female pelvis and reproductive organs. It is often used to assess women who suffer from chronic pelvic pain but have no diagnosis or who are experiencing dysfunctional uterine bleeding. A pelvic MRI is suggested when an ultrasound does not identify the problem. It may also be a better option since an MRI provides better visualization of the organs for masses in the pelvis.

What should I expect?

You will be asked to lie down on an MRI table. The table will move into the MRI scanner. Once the technologist has positioned you in the scanner, a series of MRI scans will be performed. The technologist will be instructing you during each scan. After the technologist reviews the scans, making sure that they are sufficient for interpretation, they will be sent to the radiologist for their interpretation.

How should I prepare?

Prior to your examination, you will be asked a series of health history questions that are critical before entry to the scanner. Patients who have a pacemaker or other metal medical devices implanted in their body may be prevented from entry. The screening process may take place more than once just to safeguard your procedure.

How do I get the results?

After your study is complete, one of our TRG radiologists will evaluate your study and report the findings to your physician. Once your physician has your results they will compare them with their clinical findings to develop your care plan.