UFE- A Procedure That Significantly Boosts Quality of Life

The Bible account of Jesus healing the woman with the flow of blood is memorable because this woman was suffering from a condition that affected her everyday quality of life. Her deep desire pushed her to seek intervention to improve her life.  Thousands of years later, we continue to see women suffer from similar conditions.  A Uterine Fibroid Embolization (UFE) could by no means be called a miracle. Still, the procedure could certainly be called a medical advancement that improves women’s lives in our modern day

Benign Tumors with Side Effects

Uterine fibroids are the most benign common tumor in women of reproductive age.  Fibroids can begin to cause significant discomfort and heavy bleeding leading to anemia.  Varied treatment options are available to manage this condition including hormone therapy and surgery that can range from the removal of the fibroids to the removal of the uterus.

Another option is the minimally invasive procedure of embolization (stopping the flow of blood) of the arteries feeding the fibroids.  Minimally invasive means the incisional opening is about the size of a pen.  The procedure is uterine sparing, meaning that you get to keep your uterus.  If a woman has heavy, painful menstrual bleeding is premenopausal and has no desire for future pregnancy then they are an ideal candidate.  Patients must collaborate with their healthcare providers to make informed decisions based on their health status.

Intervention That is Minimally Invasive

Minimally invasive procedures are designed to minimize the disruption to a patient's life, offering a quicker recovery time and less discomfort in comparison to traditional surgery. Such minimally invasive procedures typically involve small incisions, less pain, and reduced risk of infection, all allowing for a faster return to daily activities. This approach not only enhances the patient’s experience but also reflects advancements in medical technology and techniques that prioritize patient well-being and outcomes.

What to Expect and How to Prepare

The prep and recovery for this procedure are also minimally disruptive to the patient’s life.  Pre procedure involves an MRI for evaluation and not eating or drinking roughly 8 hours before the procedure.  If you are on blood thinning medications those will be stopped typically 24 to 48 hours pre-procedure.  The nurse will start an IV on the patient and put a catheter into the bladder.  The catheter empties the bladder for better visualization of the uterus during the procedures.  During the procedure the patient will receive pain and sedation medication and depending on the provider a gastrointestinal block.  Access to the uterine arteries is achieved by the femoral artery at the groin. Access is gained to the femoral artery by Ultrasound guidance and the area is numbed before the catheter is placed.  The arterial catheter gains access to the uterine arteries and embolic agents are placed strategically to stem the flow of blood feeding the uterine fibroids.  When blood supply is cut off from the fibroids they begin to shrink and are eventually reabsorbed into the body. 

Post procedure the patient receives pain and nausea control medications and is typically kept overnight for pain control.  The foley catheter is removed once the patient can get up and use the toilet for herself.  The best way to describe the 48-hour period post is life having the flu.  There is a significant amount of inflammation caused from embolizing the fibroids.  The first 24 hours can entail a large amount of abdominal cramping, and this is why many providers admit their patients overnight.  Recovery is about a week post procedure with cramping, pain, abdominal heaviness, and fatigue. 

Women can’t elect for a miracle, but medical advancements in elective surgery do allow for a choice.  A detailed discussion with your healthcare provider can help you to assess if a UFE could improve your quality of everyday life.

References

van der Kooki, S. M. (2024, March 26). Uterine fibroids (leiomyomas): Treatment with uterine artery embolization. UpToDate. https://www.uptodate.com/contents/uterine-fibroids-leiomyomas-treatment-with-uterine-artery-embolization?search=ufe&source=search_result&selectedTitle=1~9&usage_type=default&display_rank=1

(van der Kooki et al., 2024)

Stewart, E. A. (2024, July 25). Patient education: Uterine fibroids (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/uterine-fibroids-beyond-the-basics?search=ufe&source=search_result&selectedTitle=3~7&usage_type=default&display_rank=3