Uterine artery embolization (UAE) is an interventional radiological procedure performed with angiographic guidance under local anesthesia. Small plastic particles are injected into each of the two uterine arteries to block the blood flow to uterine fibroids or adenomyosis. The procedure can be chosen by patients as an alternative to a hysterectomy.
What are Uterine Fibroids?
Uterine fibroids are benign (non-cancerous) growths in or on the walls of the uterus. They can range from less than an inch around to more than six inches. The disease usually occurs in women older than 30 who have had children. It is more likely in women with previous cesarean section or other uterine surgery.
Uterine fibroids are very common. As many as one in five women may have fibroids during their childbearing years. Half of women have fibroids by age 50. African-American women and those with a family history are more likely to develop fibroids. Doctors don't know the cause of uterine fibroids, but research and clinical experience point to genetic alterations, hormones and other chemicals.
What is Adenomyosis?
Adenomyosis is a thickening of the uterine wall that occurs when endometrial tissue, which normally lines the uterus, moves into the outer muscular walls of the uterus. Adenomyosis (which may coexist with fibroids) causes enlargement of the uterus, heavy periods and pain and tends to be progressive. It may affect fertility and it may also coexist with a condition called endometriosis where these womb lining cells are present in the peritoneal cavity.The cause of adenomyosis is unknown. Sometimes adenomyosis may cause a mass or growth within the uterus, which is called an adenomyoma.
Your doctor may conduct an ultrasound exam if he/she suspects uterine fibroids or adenomyosis.
Preparing for an Ultrasound Exam
Preparation for your ultrasound exam is determined by the part of your body to be examined.
- Wear comfortable, loose-fitting clothing for your ultrasound exam.
- Remove all clothing and jewelry from the area of your body being examined prior to the exam as these objects interfere with the quality of the images.
- The portion of your body that is being examined will be undressed and you may be asked to wear a hospital gown to cover yourself during the exam.
If you are being scheduled for an ultrasound of the pelvic area or for a pediatric exam, your physician may ask you to prepare by fasting or to consuming liquids in advance of your exam. Please ask your doctor.
You may continue to take regular medications.
A radiologist will review your exam images and report the findings to your doctor. Your doctor will then discuss the findings and next steps with you.
What to Expect During a UAE Procedure
In a uterine artery embolization (UAE) procedure, physicians use an X-ray camera called a fluoroscope to guide the delivery of small particles to the uterus and fibroids. The small particles are injected through a thin, flexible tube called a catheter. These block the arteries that provide blood flow, causing the fibroids to shrink. Nearly 90 percent of women with fibroids experience relief of their symptoms. UAE reduces the recurrence of uterine fibroids and adenomyosis and has much lower complication rates when compared to surgical alternatives, such as a hysterectomy.