What to Expect for a UFE Procedure
Patient Evaluation
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Your visit to the Fibroid Specialists of University Vascular for a fibroid embolization will begin with a review of your medical history, followed by a physical exam. In most cases, uterine fibroids can be diagnosed using ultrasound, but an MRI scan may be helpful in better characterizing the fibroids and may be preferred by your interventional radiologist to rule out other conditions. In addition to confirming your diagnosis, these imaging techniques will allow your fibroid specialist to prepare for your UFE procedure and ensure that it is the right treatment for you.¹
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How to Prepare for Uterine Fibroid Embolization Surgery?
Stay well hydrated the day before your procedure with plenty of water. Starting at midnight before the day of your procedure, stop taking anything by mouth, with the exception of blood pressure medications which should be taken as prescribed. If you have any questions about this, do not hesitate to ask your doctor.
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The Day of Your Uterine Fibroid Embolization Procedure
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The day of, plan to arrive to the clinic 15 minutes early, and make sure to have a photo ID or driver’s license, your insurance card if you have insurance, and any forms the clinic may have sent you. After checking in with the receptionist, the staff will provide you with a disposable gown and will be able to answer any questions you may have. You will also have an IV placed in your arm for medications and fluids. There are no major incisions required for the UFE procedure. In preparation for the procedure, staff will check your pulse either in the forearm or the upper thigh where a tiny puncture will be made to deliver the therapy.
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During the UFE Procedure
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Before the UFE procedure begins, you will move yourself to a bed attached to scanning equipment which allows the interventional radiologist to take fluoroscopy (live X-ray) images during the procedure. In most cases, you will not require general anesthesia and will not be “put to sleep”. Rather, conscious sedation is used to relax you and maintain pain control during the UFE procedure.² During the procedure, your interventional radiologist will take fluoroscopy images to guide the treatment.
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How Long Does Uterine Fibroid Embolization Procedure Take?
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The procedure takes an average of one hour. While you will be awake throughout, a specialized nurse will be monitoring you to keep you comfortable and you should only feel slight pressure at the puncture site.
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What To Expect After UFE Procedure?
After your UFE procedure, you will be taken to a recovery room, where you will be monitored for any puncture site bleeding and pain control. The decision of how long a patient is monitored is generally made by the interventional radiologist performing the procedure. If a puncture was made in the femoral artery in the upper thigh, recovery will include lying flat for a specified period of time.
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In most studies, recovery time for women who have undergone a UFE procedure averages between 9-12 days, however, this will vary from patient to patient. You can plan for about 1-2 weeks for recovery, after which you can gradually return to normal activities like work and exercise. Use pain and discomfort as a general guide for activity, however, avoid sex for at least 1 week post-procedure. The normal course of recovery includes some vaginal bleeding (this may vary between women), which should become lighter in the months following the procedure. Avoid the use of tampons for 1 menstrual cycle post-procedure.
Cramping pain is normal and is generally present for 3-4 days and will become less frequent in the following 2 weeks. NSAIDs like ibuprofen can help with this pain and are generally adequate. Additional pain control with oxycodone for the first 48 hours may be prescribed, along with a stool softener such as docusate sodium to avoid constipation from the medication. If needed, anti-nausea medication is also available.
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If you experience any fevers, chills, or foul-smelling vaginal discharge, this may indicate that there is an infection in your uterus. These symptoms should be brought to the attention of your doctor immediately.
References
[1] Bulman, J.C., Ascher, S.M., Spies, J.B. (2012). Current Concepts in Uterine Fibroid Embolization. RadioGraphics, 32(6), 1735-1750.
[2] Siskin, GP., Bonn, J., Worthington-Kirsch, RL., Smith, SJ., Shlansky-Goldberg, R., Machan, LS., Andrews, RT., Goodwin, SC., Hovsepian, DM. (2002). III. Uterine fibroid embolization: Pain management. Techniques in Vascular and Interventional Radiology, 5(1), 35-43.