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UFE Procedure
Uterine Fibroid Embolization is performed at Houston Northwest Medical Center in our outpatient Interventional Radiology
suite. Prior to scheduling UFE, patients are evaluated by our Interventional Radiologist at our clinic. Appointments in our clinic are made by calling 281-880-6947. Once scheduled for UFE, patients register through Medical Mall II (281-440-2222) and the Ambulatory Care Center (281-440-2286). All required paperwork and laboratory tests can be completed during this registration visit. On the morning of the procedure, patients report to our Interventional Radiology center at 800 Peakwood by 0730 AM. You will change into a gown and a nurse will place an IV in your arm. This IV will be used to administer antibiotics prior to the procedure as well as medications during the procedure for pain control and sedation. The nurse will also place a Foley catheter to keep the bladder drained during the procedure. The x-ray dye given during the procedure is excreted by the kidneys and quickly accumulates in the bladder. A bladder distended with x-ray dye will obscure the uterus making it very difficult to see the uterine arteries. Additionally, most patients are more comfortable having their bladder drained by a Foley catheter while lying flat for the recovery period.
You will then be taken to the Interventional suite and your groins will be shaved if necessary and cleansed with betadine. Sterile drapes will be placed. Intravenous medications will be administered for sedation, pain control, and nausea. The Interventional Radiologist will apply local anesthetic to the skin and soft tissues in your groin to make the area numb. A needle is inserted into the femoral artery in the groin. A wire guide is then fed through the needle into the artery. The needle is then removed and a small caliber catheter is threaded over the wire guide into the artery and guided under x-ray into one of the uterine arteries. X-ray dye will be injected to demonstrate the arterial supply to the uterus.
Once the catheter is appropriately positioned in the uterine artery, small
particles called Embospheres will be injected while watching under x-ray. When the Interventional Radiologist determines that the flow through the uterine artery has diminished appropriately, the catheter will be repositioned into the uterine artery on the other side for embolization. Both uterine arteries must be embolized in order for the treatment to be effective. Occasionally, both groins are utilized in order to gain access to both uterine arteries due to anatomical considerations. After embolization of the second uterine artery is completed, the catheter is removed from the artery.
Patients usually begin experiencing moderate pelvic cramping near the end of the procedure. Strong intravenous pain medications called narcotics are administered to control this pain. Anti-inflammatory agents and anti-nausea medications are also given. All patients experience pelvic pain following the procedure. The intensity of the pain is quite variable from patient to patient. It is not possible to predict how much pain each individual patient will experience. The medications given during and after the procedure are usually very effective in allieviating the pain from the procedure.
After the procedure is completed, the catheters will be removed and 10-15 minutes of gentle compression will be applied at the groin by hand to seal the small puncture created in the femoral artery. You will need to lie flat for about 6 hours without bending the hip to allow the puncture site to seal properly. A Patient Controlled Analgesia (PCA) pump will be initiated to deliver intravenous pain medication on demand by depressing a thumb trigger. You will be admitted overnight to the Women's Atrium for observation and pain control. During the night, you will be transitioned from intravenous to oral pain medications. The Foley catheter will be removed when you are able to walk and go to the restroom. Your IV will be removed when you are tolerating food, liquids, and medications by mouth. You will be discharged the next morning with detailed instructions and several prescription medications for pain and nausea. We will follow-up with you by telephone within 24 hours. You should refrain from any strenuous activity for the next 48-72 hours. Most people are able to return to work within 3-5 days. Another ultrasound or MRI will be performed in 6 months to assess how much the fibroids have shrunk.
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