Most patients will experience
several hours of moderate to severe pain after the
procedure. There may also be nausea, and possibly fever.
The pain and nausea is controlled with intravenous
medications, usually with a pump that allows
self-administration of the medications. After an initial
period of bed rest for six to eight hours, those
patients with mild to moderate symptoms may be
discharged. Most patients are hospitalized overnight.
Most symptoms are substantially improved by the next
morning allowing discharge from the hospital.
After discharge, most patients will have periodic
moderate to severe cramping over several days. Pain
medications are prescribed to control these symptoms.
These cramping episodes usually diminish over several
days. Most patients will feel tired and may have a fever
or nausea periodically. All these symptoms usually
resolve over several days, but may last longer. Most
women can anticipate returning to work 7 to 14 days
after the procedure.
anticipated in less than 3% of patients. Serious
possible complications include injury to the uterus from
decreased blood supply or infection. Fortunately, this
is quite rare and hysterectomy to treat either of these
complications occurs in less than 1% of patients.
Injuries to other pelvic organs is possible but has not
yet occurred and the chance of other significant
complications is less than 1%.
Long-term complications are not expected, although
several questions about potential side effects remain.
X-rays are used to guide the procedure and this raises a
concern about potential long-term effects. In a study
measuring the X-ray exposure during uterine
embolization, the exposure was found to be below the
level that would be expected to cause any health effect
to the patient herself or to future children.
is also uncertain what effect blocking the uterine
arteries will have on the ability to become pregnant or
to carry a pregnancy to term. The large majority of the
patients that had this procedure are finished with
childbearing and so few women have tried to become
pregnant after this procedure. Thus far, at least a
dozen patients have become pregnant after this procedure
worldwide. This includes a normal cesarean twin delivery
and several normal single vaginal deliveries in France.
There has been one reported miscarriage and other
patients are pregnant at this time. It is also known
that patients who have had this procedure for other
reasons, such as bleeding after childbirth, have
successfully carried pregnancies. However, most patients
that have been treated for fibroids thus far are not
interested in having a baby and have not sought to
become pregnant. Therefore, without further study, we
will not know what percentage of patients that wish to
become pregnant will be able to do so.
Another unresolved question is the effect, if any, of
this procedure on the menstrual cycle. The overwhelming
majority of women who have had embolization of fibroids
have had decreased bleeding with normal menstrual
cycles. There have been a few women (most of whom are
near the age when menopause would be expected) who have
lost their menstrual periods after uterine embolization.
It is uncertain whether these cases are a result of
decreased ovarian function from the procedure. This
question will require further study. Based on this
limited information, it appears that this procedure may
result in loss of menstrual cycles (premature menopause)
in a very small number of patients.
As of this time,
approximately 2000 to 3000 patients have had this
procedure world-wide. Initial results suggest that
symptoms will be improve in 90% of patients with the
large majority of patients markedly improved. Most
patients have rated this procedure as very tolerable.
The expected average reduction in the volume of the
fibroids is 50% in three months, with reduction in the
overall uterine volume of about 35%. The long-term
outcome is not known, in that the arteries could reopen
or collateral vessels could be recruited which might
allow regrowth of the fibroids. As of yet this has not
been reported in the published series but only short
term follow-up is available. Therefore, it is not yet
known if the fibroids can regrow.
This section was written to provide patients with an
overview of uterine fibroid embolization. If you are
interested in a more detailed discussion of the reported
results, we encourage you to read our references.
If you would like to consider this procedure at the
Fibroid Medical Center of Northern California, please
feel free to contact us.