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Uterine Artery Embolization

Q: I have several fibroids and my doctor told me that there's a new procedure I can have instead of a hysterectomy called "UAE." What is UAE?

- Confused in Seattle

Dr. Donnica:
UAE stands for uterine artery embolization. This is a relatively new, minimally invasive procedure designed for certain women with large or numerous fibroids who are symptomatic. Its goal is to eliminate the need for hysterectomy in a large percentage of women with fibroids. Essentially, it is a procedure similar to cardiac angiography performed by interventional radiologists on an outpatient basis. A thin catheter is inserted into the major artery of the leg (the femoral artery) and threaded to the uterine artery. Tiny spongy particles are then injected into the uterine artery, obstructing blood flow to the uterus. This causes fibroid tissue death and reduced fibroid size as a result. The uterus itself usually gets sufficient blood flow (and thus oxygen) from other sources and can therefore survive.   After the procedure, women may experience cramping, labor-like pain for 24 hours. The recovery period is 3-7 days. 

So far, no large-scale clinical trials have been completed to demonstrate the long-term success or complication rate. This procedure is generally restricted to women who are not interested in or able to have subsequent pregnancies; the effect of this procedure on fertility is unknown. There are women who have gone on to have normal pregnancies after UAE. However, 1-2% of women who have had it went in to early menopause as a result of reduced blood supply to the ovaries. In addition, a small percentage of UAE patients required hysterectomy after complications of the procedure.  UAE may be tried in women who want to preserve their fertility when symptoms recur after conventional therapies have already been tried.

Because of the newness of this procedure, it may not be fully covered under your health insurance plan, so be sure to check. Most major health insurance plans are now providing full coverage. UAE can cost up to $15,000.

Created: 8/15/2002  -  Donnica Moore, M.D.

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