Uterine artery embolization (fibroids or adenomyosis)

Background and indications

Uterine fibroids and adenomyosis can cause heavy menstrual bleeding, pelvic pain and heaviness sensation. Uterine artery embolization is a recognized alternative to myomectomy or hysterectomy.

Benefits

Uterine preservation, significant symptom improvement in 85-90% of cases (reduced bleeding and pain), fast recovery (1-2 weeks vs 4-6 weeks for surgery), outpatient or short hospitalization.

Procedure

Under local anesthesia and sedation, a catheter is introduced via the radial (wrist) or femoral (groin) artery and guided successively into the right and left uterine arteries. Embolization microspheres are injected to block blood supply to the fibroids or adenomyotic tissue. The procedure lasts 1-2 hours.

Risks

Post-embolization syndrome is common (pelvic pain, nausea, mild fever) for a few days. Rare complications include uterine infection, permanent amenorrhea (especially after age 45), or vaginal fibroid expulsion. Impact on future fertility should be discussed case by case.

Recovery and follow-up

One-night hospitalization or outpatient. Pain management with analgesics. Follow-up MRI at 3-6 months to assess fibroid reduction. Symptoms improve gradually over 3-6 months.

Practical information

Local anesthesia. Outpatient procedure (return home the same day).