Embolization of uterine fibroids

What is uterine fibroid embolization?

Embolization of uterine fibroids is a new treatment for these benign tumors in which surgery is avoided, since it is performed using radiology.

This technique is performed by an interventional radiologist, who is a physician specialized in treatments under radiological control and who is specially trained to perform the procedure.

Why is it performed?

In the beginning, embolization of uterine fibroids was performed to contain and limit bleeding during open surgery, since these tumors are very vascularized. Currently it has been proven that with endovascular embolization the symptoms are resolved and it is not necessary to proceed to surgery to complete the treatment.

Embolization is performed under general anesthesia through a 3 mm incision in the groin that allows the introduction of a fine catheter that advances, guided by X-rays, towards the uterine artery that keeps the myoma active. Thus, once in the right place, small microparticles are injected which are carried to the fibroids by the blood flow, where they obstruct the vessels, cutting off their blood supply and causing them to decrease in size and the symptoms to disappear.

Uterine fibroid embolization is performed by an interventional radiologist.

What does it consist of?

Embolization is performed under general anesthesia through an incision in the groin of 3 mm, is to place a catheter intrarterially puncturing the femoral artery through the skin. Under radiographic control, this catheter is directed into the uterine arteries and, once in the right place, small particles are injected which close off the small arterial branches that nourish the myoma. The tumor tissue dies and the myoma shrinks in size and, in most cases, the symptoms disappear.

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The particles used are made of different materials, all of which are safe and effective, and they are anchored in the uterine arteries so that they cannot break free and circulate to other parts of the body.

Preparation for embolization of uterine fibroids

Before the intervention is performed, a gynecologist must confirm whether the symptoms that the patient presents and that motivate this procedure are really due to the presence of fibroids. In addition, an MRI or ultrasound study will be performed to assess the number of fibroids, their precise location and size.

Laparoscopy may also be performed to directly view the surface of the abdominal and pelvic organs.

If bleeding is the most important symptom suffered by the patient, a biopsy of the endometrium is indicated to rule out cancer.

Care after the operation

After the operation, the patient is advised to take it easy, avoiding strenuous activity during the first week. As for sexual matters, the specialist should be consulted, but it is recommended to wait about a month to resume sexual relations.

Alternatives to this treatment

The option of traditional surgery for removal of fibroids is performed through an incision and opening in the abdomen or vagina. There are two types:

  • Myomectomy: It is practiced only and exclusively the exeresis of the myoma, preserving the uterus that must be reconstructed during the surgical act. This technique does not prevent the possibility that new uterine fibroids may reappear in the future.
  • Hysterectomy: This surgery consists of total removal of the uterus. Complete removal of the uterus is only indicated in cases of massive bleeding that does not stop with other techniques, in perimenopausal women who do not wish to have more children and with other gynecological diseases (CIN, endometriosis…) or with very disabling symptoms.