Embolisation

UTERINE ARTERY EMBOLISATION (UAE)

UAE is performed by an experienced invasive radiologist. This is a method where a catheter (tube) is inserted under X-ray guidance through the right groin via the right femoral artery into both uterine arteries, and microscopic particles are applied through this catheter to block both main trunks of the uterine arteries. This procedure does not endanger the uterus, which has a vascular supply from other arteries, but the blood flow to the fibroids is significantly reduced, which leads to their gradual reduction, sometimes even by half. The effect will be fully manifested in 3 to 6 months. Although the fibroid(s) will not completely disappear, the intensity of unpleasant symptoms (heavy or irregular bleeding, lower abdominal pain, frequent urge to urinate, etc.) is significantly reduced in 80 to 90% of cases.

Procedure

The patient is hospitalized for 1 to 3 days at the Department of Gynaecology and Obstetrics of the Thomayer University Hospital. For the procedure itself, the patient is brought by ambulance to the radiology department of IKEM, from where she is returned after embolization. On the first day, the patient is monitored in the intensive care unit, and then in the standard inpatient ward.
Ultrasound guidance and catheter insertion into the main trunks of the uterine arteries are performed under local anaesthesia. Since embolization is usually accompanied by the post-embolization syndrome (nausea, vomiting, lower abdominal pain, elevated body temperature), the patient is also given epidural or intravenous analgesia, which relieves these symptoms usually lasting 1 to 2 days.
UAE represents an alternative to surgery where there is a high operative risk due to either previous surgeries or a larger number of fibroids.
In order to assess the condition of the uterine cavity and its mucous membrane lining, we suggest that the woman undergo a follow-up hysteroscopy 2 to 3 months after the embolization. At the same time, we will check the hormonal levels to exclude unwanted embolization of the vessels that supply the hormonally active ovaries.
Postoperative checks are to be performed 1, 6 and 12 months after the procedure in the Outpatient Endoscopy Clinic of the Department of Gynaecology and Obstetrics.

However, myomectomy still remains the gold standard for women planning pregnancy.