Sydney Fibroid Clinic

Uterine Artery Embolisation Periprocedural Care

Patient Information by Dr Eisen Liang


Now you have decided to go ahead with Uterine Artery Embolisation to manage your symptoms of fibroid or adenomyosis. The following information is to enhance your understanding and make you at ease about the procedure and its aftercare.



How do I prepare for the procedure?


You should be fasting from midnight if you are on the morning list. You can have a light breakfast if you are on the afternoon list. Small amount of clear fluid and your usual medications are allowed until the time of the procedure.


The hospital will ring you to give you instructions as when and where to go for admission.



What happen on the procedure day?


After admission, you will be prepared for the procedure.


An IV cannula will be placed for sedation, analgesics and antibiotics.


A bladder catheter will be inserted to prevent contrast collection in the bladder that will block the view arteries on X-ray. The catheter also ensures safety and comfort when you are having PCA (patient controlled analgesia) that may make you drowsy.


The procedure is performed in the angiographic suite. Sedation and local anaesthetic will be given. You are conscious but relaxed.


The procedure itself is not painful. The pain from lack of oxygen supply to the fibroids and uterus occurs after the procedure.



How do I recover from the procedure?


You will need to lie still for 4 hours after the procedure to avoid bleeding from the groin entry site.


You may experience some degree of post embolisation syndrome, which consists of pain, nausea, low-grade fever and lethargy.


As soon as you start to experience pain, ask the nurse to initiate the PCA. You will be asked to assess the severity of your pain by visualizing on a scale of 0-10. If PCA was inadequate, additional analgesics can be given. The first 8 hours will be the worst for pain.


You will not have a good appetite for the first few days. If you were feeling nauseated, please ask the nurse for antiemetics.


Day 1: When the pain is under control with oral medications, the PCA can be stopped and the bladder catheter can be removed. If you are drinking adequately, the IV cannula can be removed. If you feel well enough, you can shower and move around.


Day 2: Your pain should be adequately controlled with the regular analgesia and you should be well enough to go home.


First week: The pain should be easing off and you will require less and less medications. There may be vaginal discharge, which might be bloody. You might be lethargic and have a low-grade fever, as if you had a flu. By the end of the week, you should expect to feel normal. Most women are well enough to return to work and normal activities after one week.



Take home medications:

Panadol 2x500mg four times a day until pain is minimal.

Mobic 15mg for few more days on top of Panadol.

Endone 5mg four times a day if Panadol and Mobic combination were insufficient.



What are the follow-up schedules?


You should make appointment to see Dr Liang 1-2 weeks after procedure to check for your recovery.


Since we have not removed your uterus, Dr Liang will need to see you for follow-up at 3, 6, 12 and 24 months.


An MRI will be arranged just before the 6-month follow-up, to allow side-by-side before and after comparison. Depending on the type and size of the fibroids, ultrasound might be required at 3, 12 and 24-month follow-ups.


You should see your GP and gynaecologist for your regular well women care such as pap smears



What do I expect and what should I watch out for?


From the first period, the heavy menses should be much lighter and the period pain should also be reduced significantly. The relief of bladder symptoms from the bulk of the fibroids might take a few months to take effect.


Spotting and vaginal discharge may occur and could linger on for several weeks. Rarely, small pieces of fibroids maybe passed.


Endometritis (infection of the uterus) is rare and occurs in 1-3 % of patients. It needs to be treated promptly. If there is intense pain, feeling unwell, chills and fever or offensive vaginal discharge, you will need to go to nearest hospital emergency for septic work up and intravenous antibiotics. Urgent ultrasound is required to exclude cervical obstruction by fibroid fragments, which might need to be removed by gynaecologist via vagina. The emergency doctors can contact Dr Liang for guidance via switchboard of the hospital where you had the procedure.