Uterine Artery Embolisation (UAE)

Uterine Artery Embolisation (UAE) is a minimally invasive procedure to treat uterine fibroids (non-cancerous growths in the womb). It blocks the blood supply to fibroids, causing them to shrink. UAE preserves the uterus and is performed by an interventional radiologist (a doctor specialising in imaging-guided procedures).

Key facts

• No surgery required – performed through a tiny incision in the groin.
• Not suitable for all fibroid types (e.g., very large or subserosal fibroids).
• Fibroid symptoms (e.g., heavy bleeding, pain) often improve within weeks.

Why is UAE Performed?

Your gynaecologist may recommend UAE if you have:

• Symptomatic fibroids causing heavy periods, pelvic pain, or bladder/bowel pressure.
• A desire to avoid surgery (e.g., hysterectomy or myomectomy).
• Medical conditions that make surgery high-risk.

Before the Procedure

• Pre-operative tests:
  • Pelvic ultrasound or MRI to map fibroids.
  • Blood tests (check kidney function and clotting).
• Preparation:
  
  • Fasting: No food for 6 hours before the procedure (clear fluids allowed).
  • Medications: Adjust blood thinners (e.g., aspirin) as advised.
  • Arrange support: Someone must drive you home and stay with you for 24 hours.

During the Procedure

• Anaesthesia: Local anaesthetic (numbing the groin) with sedation (you’ll be relaxed but awake).
• Procedure:
  
  • A small incision is made in the groin. A thin tube (catheter) is guided into the uterine artery using X-ray imaging and tiny particles are injected to block blood flow to fibroids.
  • The catheter is removed, and pressure is applied to the incision.
• Duration: 1–2 hours.

What you might feel:

• Warmth or tingling as the particles are injected (normal).

Risks and Complications

• Common (temporary):
  • Post-Embolisation syndrome: Cramping, nausea, fever, or fatigue for 3–7 days.
  • Vaginal discharge/bleeding for 1–2 weeks.
• Rare but serious:
  
  • Infection, uterine injury, or non-target embolisation (blocking blood flow to ovaries).
  • Premature menopause (if ovarian blood flow is affected).
  • Fibroid passage (expulsion) causing pain.

Recovery

In the hospital:

• Stay for 4–24 hours for pain management.
• Pain relief (e.g., strong NSAIDs or opioids) is provided.

At home:

• Rest: Avoid heavy lifting, exercise, or driving for 1 week.
• Pain management: Use prescribed medications and a heating pad for cramps.
• Return to work: Most resume normal activities within 1–2 weeks.

Follow-up:

• MRI/ultrasound at 3–6 months to check fibroid shrinkage.
• Symptoms often improve within 1–3 menstrual cycles.

Long-term effects

• Fibroid shrinkage: 40–60% reduction in size; symptoms improve in ~85% of women.
• Fertility: UAE may reduce fertility – discuss with your gynaecologist if planning pregnancy.
• Fibroid recurrence: 10–20% risk over 5 years.