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| Uterine Artery Embolization Uterine artery embolization (UAE) is a medical procedure performed for the treatment of either uncontrolled uterine bleeding or symptomatic uterine fibroids. UAE is performed by an interventional radiologist who is skilled in angiographic techniques and embolization. Uterine fibroids or leiomyomata are a common condition occurring in 20-25% of women of childbearing age. Fibroids are a benign growth of the uterus and may cause symptoms of heavy/prolonged menstrual bleeding or bleeding in between periods. In addition, large fibroids can cause pain as well as symptoms of constipation or urinary urgency/frequency secondary to compression of the colon and bladder. Until recently, the most frequent treatment for symptomatic uterine fibroids was surgery, either hysterectomy or myomectomy. In the United States more than 250,000 women a year undergo hysterectomy for the treatment of uterine fibroids. History of Uterine Artery Embolization Uterine artery embolization has been utilized for more than twenty-five years for the control and treatment of life threatening uterine bleeding. Within the last six years UAE has encompassed the successful treatment of uterine fibroids. A Parisian gynecologist (Dr. Ravina) was the first to employ the angiographic treatment of fibroids. He realized that UAE could be used to prevent operative bleeding in patients who were to undergo myomectomy. Another group of his patients who were anemic because of bleeding related to fibroids were also treated with uterine artery embolization prior to their planned hysterectomies. When these patients returned for their surgery following embolization it was found that the fibroids had significantly decreased in size and that the patient's symptoms had also improved. Because of these results Dr. Ravina decided to offer this procedure as an alternative form of treatment to his patients suffering with uterine fibroids. In 1994 he published a report of the successful treatment of fibroids by UAE; this has led to the use of UAE as an alternative to surgery for the treatment of symptomatic fibroids. Procedure During this procedure the radiologist inserts a catheter (a thin tube) into an artery in the patient's groin. This catheter is guided into the uterine arteries on either side of the pelvis and occlusive particles are injected. These particles block the arteries supplying blood to the fibroid causing it to shrink and atrophy. In patients with heavy bleeding, blocking these same arteries will stop the bleeding. UAE is performed under local anesthesia and intravenous sedation. The embolization procedure takes about sixty to ninety minutes to perform. The patient is usually kept in the hospital over-night but in some cases may go home later that same afternoon. For the first ten to twelve hours after embolization patients may experience pelvic cramps and pain. Patients can return to normal activity in two to three days, and with none of the side affects related to a major surgical procedure. UAE has a low incidence of complications. UAE is over 94% successful in relieving the symptoms of uterine fibroids. Tower Imaging and UAE Dr. Louis Adler started performing Uterine Artery Embolization in 1997. Since then he has done over two hundred and seventy-five cases, encompassing the largest series on the West Coast. Nationally published data for both minor and major complications of UAE is 2%, with Dr. Adler reporting a less than 0.5% complication rate. Uterine Artery Embolizations are performed by Dr. Adler at Saint John's Health Center in Santa Monica, CA. |
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