Afterwards

After Fibroid Embolisation

Following the embolisation procedure you will be taken back to your room where you will be looked after by nursing staff familiar with looking after embolisation patients. You will need to lie flat for a few hours to reduce the risk of bleeding from the puncture sites in the groins. You will have the morphine pump to control any pain and the nursing staff can give medication to relieve any nausea caused by the morphine. A one night hospital stay is the norm and you should be ready to go home by lunchtime the day after the procedure.You can return to normal activities almost immediately but may experience some fatigue and crampy pain (like severe period pain) for a few weeks. You should not drive for 48 hours and it is advisable to book about 10 days off work.

The results of studies that have been published or presented at scientific meetings report that 78 percent to 94 percent of women who have the procedure experience significant or total relief of pain and other symptoms, with the large majority of patients considerably improved. The procedure is successful even when multiple fibroids are present. Unlike hysterectomy or myomectomy embolisation does not physically remove the fibroids but shrinks them. 80% reduction in volume over 12 months is achievable but shrinkage of larger fibroids is less predictable. Symptoms may still improve with a lesser degree of shrinkage.

Follow up

The usual follow up consists of an ultrasound scan at 6 months and an MRI scan at 12 months. Dr. Crowe or your gynaecologist can of course see you earlier if required and if you have any concerns post procedure you should get in touch to make an earlier appointment.

What are the Possible Complications?

Any procedure carries some risks and the important thing is to be aware of what complications can arise so that early signs of trouble are appreciated and treated. UAE remains a very safe procedure.

Infection

The most potentially serious complication is infection in the degenerating fibroids occurring anything up to several months following the procedure itself. If you develop a high temperature or bad smelling discharge at any time in the months post procedure you should see your GP, gynaecologist or radiologist immediately for further advice. A course of antibiotics may be necessary.

Post Embolisation Syndrome

This is a mild flu-like condition sometimes with a minor temperature. It is helped by the painkilling tablets which you will be given to take home with you. It should not last more than a week.

Periods

It is not uncommon for your first period to be either missed or heavier than usual after the procedure, it is rather unpredictable. Following that your periods should return to normal. Due to the risk of infection and the possible passage of fibroid material you should use pads rather than tampons for at least 6 months following embolisation.

Vaginal Discharge

You may have a vaginal discharge for some weeks after the procedure. If you feel otherwise well, this is not a cause for alarm. It represents dead fibroid tissue being expelled from the womb and it should eventually clear up. Although occasionally solid lumps of fibroid tissue may be passed it more commonly appears as whitish stringy material that may be mixed with blood clot at the time of your period. Again this is not a cause for concern.

Missed Malignancy

Although fibroids are benign (non-cancerous) growths there are rare cases of fibroids converting to uterine sarcoma, a form of uterine cancer. Such cases are exceedingly rare but obviously an embolisation which does not remove the fibroids can miss such tumours while hysterectomy will ensure removal.

Ovarian Failure

If particles enter the ovarian artery during the procedure it is possible that ovarian failure and early menopause may result. This is a very small risk as all measures are taken during the embolisation to prevent particles ending up where they shouldn’t (so called non-target embolisation). A blood test taken before the embolisation (FSH or follicle stimulating hormone) provides a baseline measure of ovarian function.