The procedure

How is it done?
The procedure is done under angiographic
guidance. After disinfection and local anaesthesia
in the groin (usually the right side), a thin flexible
femoral sheath is introduced into the femoral artery.
Then a small catheter is introduced through the
sheath and manipulated under angiographic guidance
till the uterine artery is reached. The embolising material
is then injected into both the uterine arteries.
In most of the patients no general anaesthesia is required.
Little sedation during the procedure is enough.

Angiographic for uterine arteries
Angiography of uterine arteries Angiography after Embolisation.

Can this embolizing material harm my normal uterus? Can they leave the uterus and circulate in my body?

The particles that we use are of special well-calculated size which means that they go mainly to the tumor and not to the normal uterine tissue. This is based on a very simple fact that the arteries supplying a tumor are usually larger than those supplying the normal tissues since the tumor is an abnormal growth that requires more blood than normal. Accordingly we use particles that are slightly larger than the size of the arteries supplying normal tissue and at the same time smaller than the size of the arteries supplying the tumor so they go selectively to the tumor in a much higher percentage than to normal tissue. Another factor is that the uterus usually has collateral circulatiaons from which it can drive blood supply when needed.
For the second question, normally from the arteries the blood go to much smaller channels called the capillaries and then to the veins and finally to the heart thereafter. Since the particles that we use are much larger than the capillaries then they can never pass the capillary phase of circulation to be able to circulate free in the body. Hence they remain where we administer them.

What to expect after the procedure?

Following the procedure you will experience pain for the first 24hours which can be well controlled with medications, in addition there might be some nausea, slight rise in temperature all of which are well controlled wtih medications.

How long do I need to stay in the hospital and when can I return to work?

In fact the procedure can be done on an outpatient basis which means that you can leave the hospital on the same day but we prefer an overnight stay in the hospital for better pain control. Usually you can resume your normal activity and return to work within few days after the procedure.

What is the incidence of complications?

According to the United States Department of Health and Human Services, Agency for Healthcare Research and Quality, Uterine artery embolization is a very safe method and, like other minimally invasive procedures, has significant advantages over conventional open surgery. However, there are some associated risks, as there are with any medical procedure. A small number of patients have experienced infection, which usually can be treated with antibiotics. There also is a less than 1 percent chance of injury to the uterus, potentially leading to a hysterectomy. These complication rates are lower than those of hysterectomy and myomectomy (7).