At the initial consultation, your clinical history and imaging studies will be reviewed by one of our interventional radiologists who will determine whether or not you are a candidate for the UFE procedure. An endometrial biopsy may be required prior to your UFE depending on your clinical history and symptoms. Once you have decided that UFE is the right treatment option for you, you will need to give your gynecologist written permission to submit a copy of your medical records to us. Once we receive a copy of your medical records, we will begin the process of obtaining insurance authorization for your UFE procedure. This typically takes one week. Once authorization is received from your insurance company, we will contact you to schedule your UFE procedure. UFE is performed as an outpatient procedure requiring an overnight 23 hour stay. It is recommended that patients arrange to take 7-10 days off from work to allow enough time for recuperation. On the day prior to your UFE procedure: You should not eat or drink anything after midnight. It is OK to take your usual medications. Please inform us if you are taking blood thinners, such as coumadin. On the morning of the procedure: Do not eat or drink anything. You may take your usual medications with a sip of water. Please pack a small bag for an overnight stay. Arrive at DeKalb Medical Center 2 hours prior to your procedure time. You will need to register in the Radiology Department. You will then be sent to the lab for blood work and then to your room. Pre-procedure medications will be administered after an IV is started. Also, a Foley catheter will be inserted into your bladder. You will then be brought to the Interventional Radiology Department. Your interventional radiologist will again discuss the UFE procedure and obtain informed consent. You will then be taken to the interventional suite and the UFE procedure will commence.

The UFE procedure is performed while you are conscious but sedated(drowsy and feeling no pain). Local anesthesia is used to numb the skin and tissues in the groin. Your interventional radiologist then makes a tiny nick in the skin and inserts a tiny catheter or tube into the femoral artery. Contrast or dye is injected to obtain a roadmap of your blood vessels. Under fluoroscopic x-ray guidance, the catheter is then threaded into the uterine artery which supplies blood flow to the fibroids. The interventional radiologists will then inject tiny plastic beads, the size of grains of sand, into the uterine artery. These particles will cut off the blood supply to the fibroids. This same process will be repeated for the other uterine artery. Both the right and left uterine arteries must be treated for this procedure to be effective. The catheter is removed and pressure is applied to the groin puncture site until bleeding stops. The groin is then covered with a bandage. The procedure typically takes approximately 1 hour. You will return to your room with instructions to keep your leg straight for the next 6 hours. Narcotic pain and anti-nausea medications will be administered as necessary. You will be spending the night in the hospital.

Immediately following the procedure as the fibroids begin to die, most patients will experience pelvic pain, cramping, nausea, low grade fever and mild elevation of the white blood cell count. These symptoms are called post-embolization syndrome, which is self limiting. The pain, cramping and nausea are most severe on the first day and tend to be most intense approximately 6- 8 hours after the procedure. We routinely admit all our patients overnight in order to treat these symptoms with narcotic pain and anti-nausea medications. Post-embolization syndrome usually resolves over the next 4 to 5 days. Most, if not all patients will be able to go home the morning after the procedure. Discharge instructions will be given to you before you leave the hospital, along with medication prescriptions to treat pain and nausea. Most patients recover from the UFE procedure in less than 1 week. Recovery can take as long as 2 weeks.

Post-embolization syndrome is more of a side effect than a complication. It consists of pain, cramping, nausea, malaise, low grade fever and mild elevation of the white blood cell count. It is well known phenomenon that occurs in all patients undergoing embolization. It varies in severity and is self limiting, tapering off over the next 4 to 5 days. Treatment is supportive with narcotic pain and anti-nausea medications administered as necessary. Non-target embolization can occur if particles inadvertently flow into arteries feeding tissue other than the fibroids. The particles used for embolization are mixed with contrast(x-ray dye). Embolization is performed by a highly skilled interventional radiologist using x-ray fluoroscopic guidance which makes it extremely unlikely for inadvertent tissue damage to occur as a result of the UFE procedure. Non-target embolization occurs in less than 1% of cases. Premature ovarian failure can occur as a result of UFE. There are connections between the uterine arteries and the ovarian arteries that can not always be seen. The theory is that the embolic particles find their way into theses connections. The ovaries as a result shut down or stop functioning. Women will then experience menopause which may be temporary or permanent. Although premature ovarian failure is more likely to occur in perimenopausal women age 45 and older, it is uncommon occuring in approximately 3% of women undergoing the UFE procedure. Passage of fibroid tissue through the cervix or fibroid expulsion can occur following the UFE procedure. This tends to occur with submucosal fibroids. It is not life threatening but usually needs to be addressed by your gynecologist. Some patients may require a dilatation and curretage procedure to completely remove all of the expelled fibroid tissue and reduce the chance of infection. Infection is very unlikely since patients are treated with antibiotics just prior to having the UFE procedure.

We will contact you after discharge from the hospital to check your progress and answer any questions. We recommend you follow up with your gynecologist approximately 6 to 8 weeks after your UFE procedure. You will need a pelvic MRI at 6 months following your UFE procedure to assess fibroid shrinkage and residual blood flow. This should be performed at one of the DeKalb Medical Center facilities to ensure consistency and uniformity of the results. We will contact you to arrange for this pelvic MRI.