Uterine Artery Embolization for Treatment of Uterine Fibroids

Obstetrics and Gynecology. Introduction Uterine fibroids are by far the most common indication for hysterectomy. Bleeding, pain, pressure effect, or a combination of these symptoms may force some women with these benign tumors to have hysterectomy, but most women with these benign tumors may be monitored without intervention, and some women may be treated medically. Because many women are uncomfortable with the idea of hysterectomy, the past decade has seen increasing interest in alternatives to hysterectomy as pharmacologic and other less invasive surgical procedures have been developed. By far, the most promising of these new approaches is uterine artery embolization (UAE), an interventional radiologic procedure which is done with the patient sedated but conscious. In this procedure, a single femoral artery is first catheterized. Then, under fluoroscopic control, the catheter is guided into one, then into the opposite uterine artery, and fine, nonabsorbable particles are injected into each uterine artery. The benefits of the UAE procedure are striking: the risks of major abdominal surgery are avoided, recovery usually takes about one week (compared with six weeks for hysterectomy), and the patient is left with no scar and no psychological issues related to loss of an emotionally charged body part.