Dr Nigel Hacking is a Consultant Radiologist at Spire Southampton Hospital and specialises in Uterine Fibroid Embolisation.
Since the opening of a fully functional Interventional Radiology Suite at Spire Southampton Hospital complex embolisation procedures can be performed, especially for fibroids, liver and kidney tumours.
What is UFE?
UFE is a way of treating fibroids by blocking off the arteries that feed the fibroids, known as the uterine arteries, with the aim of shrinking the fibroids.. It is performed by a radiologist, rather than a surgeon and is an alternative to having an operation such as hysterectomy.
Fibroids are benign (non-cancerous) growths that develop in the wall of the uterus. They occur in 30-70% of women and whilst fibroids do not always cause trouble, abdominal swelling, heavy or prolonged bleeding and pressure symptoms on the bladder and bowel are common. They typically shrink after menopause when the level of oestrogen, the female hormone that circulates in the blood, decreases dramatically. However, menopausal women who are taking hormone replacement therapy may not experience relief of symptoms. Fibroids range in size from that of a pea to the size of a melon. In rare cases they can grow so big that the woman can look pregnant.
Fibroids only need treatment if they are causing problems. Many women go through their lives having fibroids without being aware of them and having no gynaecological symptoms. However, if treatment is necessary, it will be important to consider the choices carefully.
About the procedure
Treatment is carried out by a specially trained doctor called an Interventional Radiologist using minimally invasive techniques. You will be sedated during the procedure. UFE involves a tiny catheter being placed into the uterine artery through a small incision in the skin in the groin area.
Using X-ray equipment the radiologist will move the catheter into the correct position, into the uterine arteries that are feeding the fibroid. A special X-ray dye, called contrast medium, is injected through the catheter to identify the fibroids blood supply. Once the blood supply has been identified, a liquid containing tiny embolic particles is injected through the catheter into the small arteries which nourish the fibroid. These particles silt up the blood vessels and cut off the flow of blood. Both left and right arteries are treated, usually both from one groin puncture.
The UFE procedure requires a 1 or 2 night stay in hospital and once at home you can resume normal activities as soon as you feel able. For some women this can take 2-3 weeks, whilst for others it can take just a few days.
The fibroids should shrink in size over the months following the operation.
UFE is a generally safe procedure. It has been reviewed by the National Institute for Health and Clinical Excellence (NICE) and the Royal Colleges of Obstetrics and Gynaecology, but there are some risks and complications that can arise, as with any medical treatment and you should ensure that you discuss all the options available to you with your Interventional Radiologist.
You can be referred by your GP to either Gynaecology or Interventional Radiology for consideration of treatment and in all cases the Radiologist and Gynaecologist will look after you together.