Interventional radiology utilises image guidance to provide minimally invasive image guided diagnosis and treatment of disease.
Common interventional radiology procedures include:
Common interventional radiology procedures include:
Trans catheter uterine fibroid embolisation (UFE) is indicated for the treatment of symptomatic uterine fibroids. UFE was first performed in 1995, since then the procedure has developed, incorporating new and effective techniques and devices.
UFE has been assessed in prospective, randomised trials (including the EMMY and REST trials). These have demonstrated that UFE is as effective as a hysterectomy in improving a woman’s quality of life – five and ten years after the procedure. (Level one evidence.)
UFE represents an alternative to hysterectomy for women with fibroids that produce severe menstrual bleeding (menorrhagia) and anaemia. It is also indicated when fibroids cause significant period pain (dysmenorrhea) and may be indicated for treatment of symptoms related to the mass effect of the enlarged fibroid uterus.
Unlike hysterectomy, UFE enables a woman to keep her uterus and retain the ability to bear children, provided there are no fertility or other issues. UFE also has a rapid recovery period.
It is imperative that all women considering UFE are appropriately investigated to determine if UFE is a suitable treatment option for them. It is also critical to exclude any form of gynaecologic cancer, infection and pregnancy. Ultrasound and MRI scans of the pelvis are performed to obtain a baseline assessment of the type, number, size and position of the fibroids. Certain types of fibroids (e.g. pedunculated fibroids) are not suitable for UFE.
A full blood count, coagulation profile and renal function tests are performed. The results are discussed at a preoperative visit.
The operation is performed in a hospital angiography suite. Using X-ray guidance, fine catheters are directed from the femoral artery into the arteries, which supply the fibroids. These arteries are blocked with very small embolic particles, resulting in the atrophy and shrinkage of the fibroids. The affected tissue is reabsorbed by the body over a period of three to six months.
It is usual to experience some pain following the procedure. Post-operative analgaesia is given to control the pain. A single dose of intravenous antibiotics is given to minimise the risk of infection.
Patients are typically discharged on the same day of their procedure or the following day. Most patients need a few days at home to recover from the anaesthetic and procedure. They are then able to return to normal activity.
Dr Luke Baker specialises in interventional radiology treatment.
Get in touch to find out more about an upcoming procedure or to book an initial appointment.