Sometimes referred to as Uterine Fibroid Embolization, this is a procedure in which tiny particles are injected into the arteries that provide blood flow to uterine fibroids. With reduced blood flow, the fibroids shrink which reduces bulk symptoms and menstrual blood loss. The procedure usually takes about 30 minutes and is performed by an interventional radiologist in a procedure room. Overnight stay in hospital is recommended because some women experience menstrual cramp-like pain for the first 6 hours.

Post-Procedure Instructions:

The Recovery Process

Over the first few days you are likely to have cramps that come and go as well as feeling as if you have the flu, with low energy, occasional nausea and possible fever. This is your body reacting to the death of the fibroid tissue.  Usually these symptoms are most pronounced in the first 2-3 days and begin to improve by the 4th or 5th day. It is unusual for these symptoms to last longer than 7 days. While you will progressively feel better, you should expect a generalized lack of energy and should gauge your activity accordingly.

Puncture Site

 If you notice any increased swelling or active bleeding from the puncture site use direct pressure by placing your fingers and a clean clothe or paper towel over the site. Report to the emergency department at the Health Sciences Centre for evaluation. There may be some bruising at the site and this is normal. Also you may feel a small lump (like a pea or bean) at the site which is normal. This usually fades in a few months. Continuing pain at the puncture site can occur due to irritation of the nerve branch that passes by the puncture site. Advil should help to reduce the discomfort. While it is possible for this discomfort to continue for several weeks or longer, this is very rare. Should this occur, please call our office at 477-3508 or contact your doctor.

Diet and Activity

Resume your normal diet and medications. Slowly increase your activity in the next 3-4 days. You may have unrestricted activity, including sexual activity and exercise, 7 days after the procedure. You could become sleepy while taking high doses of pain medication so be careful about driving or operating machinery.

Possible Side Effects

Pain – Pelvic pain is due to lack of blood flow to parts of the uterus. The greatest pain begins after the procedure and persists for 6-12 hours. The first week at home you may feel cramps not unlike bad menstrual cramps. This should be tolerable with the assistance of pain medication (usually a combination of Tylenol #3 and Naprosyn)                                                                                

Nausea - Take an over the counter anti-nausea medication as needed. If this does not help call your doctor.

Constipation - Use any of the following: Colace, Surfak, Milk of Magnesia, Metamucil, Senokot, Bran, prunes, and drink 8 glasses of water a day. If this does not help call your doctor.

Vaginal Discharge - a brown or reddish brown discharge or spotting after the embolization is considered normal and may continue for a few weeks. Use a sanitary napkin until it resolves. It is preferable to not use a tampon for 1 week. External sanitary pads are better. A clear watery discharge for several weeks or even months does not indicate infection. Of concern is a thick or foul smelling discharge or heavy bleeding, particularly if fever or pelvic pain accompanies it. Call your doctor if this occurs.

Menstrual Cycle – You may begin early or skip a period or two for the first few months. As well you may experience more uncomfortable cramps during the first period or two following the procedure. Improvement varies with the individual and can begin from immediately to 3 months.

Hormonal Changes – Some patients may experience symptoms as a result of changes in their hormonal levels after the procedure. This is the result of decreased blood flow to the ovaries which is usually temporary. Some women experience mild depression, which subsides within a few days. Others experience “hot flashes” and/or night sweats that may persist for a few weeks. These symptoms most often resolve by themselves.

Main Concerns and Reasons to Contact Your Doctor

• Swelling or active bleeding from the puncture site
• Pain that arises several days or weeks after the initial pain is resolved and is not controlled by Tylenol and Naprosyn
• A temperature that persists several days after the procedure (>38°)
• Foul smelling or copious vaginal discharge, or heavy vaginal bleeding