Are you also suffering from heavy bleeding due to uterine fibroids? Let's learn about (Uterine Artery Embolization)!

Do you bleed more than usual during your period? Or do you constantly feel tightness and pain in your lower abdomen? The main cause of these symptoms can be non-cancerous tumors called fibroids that form in the uterus. Today, we are going to talk about an effective method to treat this condition that does not require major surgery.

Simply put, what is Uterine Artery Embolization (UAE)?

Uterine Artery Embolization (UAE) is a minimally invasive procedure that uses a very small incision, without a large incision. It essentially blocks the blood vessels (arteries) that supply blood to your uterus.

This treatment is often used to control excessive bleeding caused by non-cancerous tumors in the uterus, called uterine fibroids . It is also used in emergency situations such as postpartum hemorrhage, bleeding due to an accident, or bleeding caused by cancerous gynecological tumors.

In what cases is UAE treatment performed?

Most often, this treatment is used for those suffering from various symptoms due to uterine fibroids. Let's take a look at what they are.

In addition to these symptoms, your doctor may also recommend UAE treatment for other conditions, such as heavy bleeding after childbirth, bleeding due to an accident, or bleeding due to cancerous tumors.

In what cases should UAE treatment not be performed?

In some cases, this treatment may not be suitable for you.

• Even if you have uterine fibroids, you don't have any symptoms.
• If you are pregnant .
• If you have an infection in your pelvic area.
• If you have a blood vessel disease.
• If you have an allergy to the specific contrast dyes used in this treatment.

How does this treatment work?

Imagine that the fetus in the womb is like a plant that is nourished by water. What would happen if we slowly closed the pipes that provide water to this plant? Without water, the plant would slowly die, wouldn't it? Something similar happens in UAE treatment.

Simply put, tiny particles, like grains of sand, are injected into the blood vessels that supply blood to your uterus (uterine arteries). These particles are guided to the exact location through a very thin, flexible tube called a catheter . This tube is inserted and a technique called fluoroscopy, which is like an X-ray, is used to watch it as it travels.

When blood vessels are blocked like this:

• Excessive bleeding is controlled.
• Fibroids lose their blood supply, and they gradually shrink and become smaller.

What should I do before treatment?

Your doctor will recommend UAE treatment after carefully examining your complete medical history and symptoms. You will need to do these things before treatment.

• Your doctor will ask about your health, allergies, medications you take, and menstrual cycle. He or she will also discuss whether you are planning to have children in the future, as this treatment can affect fertility.
• To determine the exact cause of the bleeding, a test such as an MRI scan , ultrasound scan , or hysteroscopy will be performed.
• Sometimes a small piece of tissue from the lining of the uterus may be taken and examined (biopsy) to see if there are cancer cells.
• You will be asked to stop taking painkillers such as aspirin, NSAIDs (e.g., Ibuprofen, Diclofenac), and blood thinners a few days before treatment.
• You will be asked not to eat or drink anything for a few hours before the treatment. Your doctor will give you specific instructions about this.

What happens during treatment?

UAE is usually an outpatient procedure, meaning you can go home the same day without having to stay in the hospital. The entire procedure usually takes about an hour and a half (90 minutes).

This is how the treatment works:

1. This treatment is performed by an Interventional Radiologist . That is, a specialist who performs minimally invasive treatments using medical imaging technology.

2. You will be made to lie on an examination table and connected to machines that monitor things like your heart rate and blood pressure.

3. An anesthetic will be applied to your groin area.

4. You will be given saline and a sedative through an IV line to relax you and make you sleepy.

5. A very small hole is made in the skin of the groin and a fine needle is inserted through it.

6. Using X-ray (fluoroscopy) and a special dye (contrast dye), a thin tube called a catheter is guided to your uterine arteries. This dye makes the blood vessels clearly visible on the X-ray.

7. Once the catheter is in place, small particles (made of gelatin or plastic) called embolic agents are injected into the blood vessel. These particles travel and block the blood vessel.

8. When the work is finished, the catheter is removed, the bleeding from the puncture site is controlled, and a small bandage is applied.

What can you expect after treatment?

Most people are able to leave the hospital and go home a few hours after treatment. After that, you can expect things like this.

• You may be asked to lie in bed for a few hours after the treatment.
• The doctor will give you painkillers and antibiotics to take home.
• A watery or mucus-like vaginal discharge may occur for several weeks.
• Moderate to severe pelvic cramps may occur within the first 24 hours. This is normal.
• Most people can resume their normal activities within a week or two.
• Your menstrual cycle may stop for a few months. When it starts again, bleeding will initially be lighter than normal, but will gradually return to normal.
• If fibroids are treated, symptoms will begin to subside within two to three weeks. Some people may even have pieces of fibroid tissue pass through the vagina. Most people feel completely healed within six months.

What are the advantages of this treatment method?

Nearly 90% of people who receive UAE treatment for fibroids experience complete or significant relief of symptoms.

What are the risks of this?

As with any medical treatment, there are some risks.

Is UAE treatment safe? Is it suitable for those who want to have children?

Yes, in most cases, Uterine Artery Embolization is a safe treatment. Your doctor will explain the risks to you based on your medical history.

However, this is a major consideration if you are planning to have children in the future. Although there have been reports of healthy births after UAE treatment, data on this is still limited. It is not yet fully known how this treatment affects fertility.

If you are pregnant or expecting children in the future, be sure to talk openly with your doctor about the risks of this treatment.

When should I see a doctor again?

It is common to experience lower abdominal pain, fatigue, mild nausea, and a low-grade fever for the first 24 hours and a few days after treatment. Most people return to normal life within 10 days.

However, if you are still experiencing severe pain and discomfort two weeks after treatment, be sure to see your doctor again.