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What is UAE?
Uterine Artery Embolization and Uterine Fibroid Embolization are the same thing; the two terms used interchangeably. Your doctor may suggest this minimally invasive surgery if you have what is known as a fibroid tumor (more commonly called a myoma). These are typically benign tumors which can be a bother because they are found in the wall of the uterus.
The uterus has a muscular wall known as the myometrium (most people only know about the endometrium, as that’s what causes menstrual flow every month for a normal woman). The issue with these fibroid masses is that they can cause pelvic pain, excessive bleeding and in some cases even press against the bladder or bowel, which can be very unpleasant.
The Uterine Artery Embolization operation is extremely simple, and in about 9 out of 10 cases the woman experiences an abatement of the symptoms mentioned above. The procedure itself is a marvel to what modern science can accomplish. What would’ve meant a hysterectomy for a woman no more than 20 years ago, today is a procedure that allows most women to go home after an overnight stay at the hospital (just to recover under sterile conditions).
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The Physiology of UAE
If you’re curious about the actual physiology of what’s happening, here’s a quick rundown. These benign tumors are removed via a catheter that’s guided by an x-ray fluoroscope (so the doctor can see what he’s poking around in). The catheter is filled with a variety of chemicals which will cause embolization to occur, that is, these chemicals block the flow of blood into the tumor (something that research has now shown will likely be done with a pill in about 10-15 years). A type of synthetic alcohol, along with a foam and micro-encapsulated spheres, make certain that the tumor loses it’s vital supply lines, which causes it to either shrink or die.
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Treatment for UAE
So, you’ve been diagnosed with the fibroid tumor and your doctor suggests the Uterine Artery Embolization treatment – what comes next? Well, in most cases, if the diagnosis was already conclusive, they’ll try to schedule you for treatment as quickly as possible; however, it’s not unusual to have to take another MRI or even an ultrasound. Once the rounds of testing have been completed, it’s time to actually perform the surgery.
Chances are, you’ll probably be in a catheter lab at the hospital under general anesthesia while the surgery is being performed. The only thing you should feel throughout the procedure is the initial needle prick to insert the anesthetic line.
As with all operations of this nature, there is a certain risk involved that cannot be underscored. 1 out of every 250,000 who undergo general anesthesia never wake up from it, so there’s the first risk you’ll be facing. Of course, that pales in comparison to the actual operation. Because you’re being treated with chemicals injected through a catheter, there’s a risk of infection, in the event that sterility hasn’t properly been achieved. Furthermore, the embolic agents don’t know to target the tumor specifically, so they may accidentally dislodge and find their way to tissues – and muscle death or lack of oxygenation to tissues isn’t something anyone wants to experience.
The good news is that if you have an experienced person performing the surgery, you’ll find that the chance of something going wrong is reduced to less than 1%, leaving little room for concern. The real risk of the operation is that sometimes the tumors can return, in which case a hysterectomy is all but certain. Be sure to consult your doctor about the impact of the Uterine Artery Embolization on fertility.