You will come to the hospital between 6:30 and 7:00 in the morning. We can arrange to do the procedure later in the day, but you cannot eat anything for 6 hours before UFE so it is best to get it done after a night of fasting. You come directly to the Radiology Department in sublevel 2 of Methodist Hospital. There you will get registered at our Front Desk and meet our nurses in our Holding Area. You will change into a hospital gown; it is a good idea to leave your valuables at home. One of our nurses will start an IV in your arm. We will also place a tube into your bladder (Foley catheter) so you do not have to struggle to get on a bed pan to urinate (as you will see below, you need to stay in bed for 6 hours after the procedure). I will go over things with you a final time and we will ask you to give your consent for the procedure and sign some paperwork. We will give you some medications through your IV that get you ready for the procedure, including an antibiotic (usually cefazolin), a medicine the reduces nausea (Anzemet), and another that stops pain and inflammation (Toradol). You are transferred from the Holding Area to the procedure room. 

This procedure room, an Angiography room, contains a special x-ray machine that allows me to use real-time x-ray (called fluoroscopy). Here you will meet our technologists. They are specially trained to assist me during the procedure. You will be asked to slide over from you stretcher onto the angio table. We then do the final preparation by cleansing the skin at your groins with an antimicrobial soap (Betadine). This soap is great for killing bugs on the skin but works best if there is no hair. So if needed we will shave away any hair at the site we are cleaning. A large drape, like a bed sheet, is placed over you to provide a barrier to infection.

We have a pretty nice sound system in the angiography suite. The music will help you take your mind off of all the technical things happening in the room. You are welcome to bring some of your favorite CD's, if you wish. We like to listen to most anything. Or you can take your chances and listen to our music! You are going to be in this room for about 90 minutes.

Our nurse will give you some medicines through your IV that will help you be relaxed and stop pain (usually Versed and Fentanyl). I put some medicine into the skin, usually the right side, where the catheter will be passed into the artery. This is a local anesthetic (Xylocaine) that makes the area numb; the same medicine a dentist uses. I will make a tiny nick in the skin through which I puncture the artery and pass the catheter that I use for the embolization. Typically, you feel none of this manipulation. When I make the injections to see the arteries most women feel a warm sensation in the pelvis. The uterus has two main arteries, one from the right and one from the left. I can usually get to both uterine arteries from one side, rarely I need to come from both groins to get both arteries. When the catheter is safely within the uterine artery I will block off the artery by injecting small particles. When the embolization is complete we remove the catheter from the artery and hold pressure on the site for about 15 minutes.

Then we transfer you back to your stretcher and you go back to the holding area for a short time. Here the nurses will show you how to use a special IV that gives you small doses of pain medicine at your request...you just hit a button. This IV is called PCA (Patient Controlled Analgesia) and allows you to be in charge of your pain medicine. It is set to a safe limit so you cannot hurt yourself by hitting the button too often. Some people wind up using a fair amount of the pain medicine, others hardly use it at all. People have various amounts of pain after the UFE. Some women have told me the pain was no worse than their monthly cycle pain. Others have had enough discomfort that they needed to stay an extra night in the hospital before giving up the PCA. Most women are in between these two extremes. Typically you begin to have some discomfort toward the end of the procedure. This escalates and gets as bad as it is going to get in about four hours. It levels off at that point, staying about the same for the next 8 hours. Then it begins to go away, and usually by the morning after the UFE you are ready to switch from the IV to pain medicine that you take by mouth, again only when you need it. 

In the morning your nurse will remove the catheter from your bladder and take out the IV if you are not using the PCA. I will come by to see you and we will decide if you are ready to go home that morning. Most women are ready to go home before lunchtime. The discomfort you have in the pelvis will come and go over the next several days. The post-embolization syndrome will cause you to feel tired and have a low-grade fever for a  few days. I will prescribe that you take ibuprofen (the same medicine in Advil, but a higher dose) for one week to help keep the post-embolization syndrome in check. I will also give you some prescriptions for pain medications that you can take if needed. I ask that you come back to see me in two weeks. If you are from out of town we can do this follow-up over the phone. Also, you can e-mail me anytime. I tend to be more accessible by e-mail than by phone since I am often in a procedure during the day and cannot come to the phone.

I request that you have an ultrasound or MRI of the pelvis at 3-months and 12-months following the UFE. I can arrange for these studies for you or your GYN or Family Practice doctor can arrange for them.

For more information, please contact me by e-mail or by phone 210.575.4343.  Or visit the Society for Cardiovascular and Interventional Radiology's www site and follow the links about UFE.

 

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This page was last updated on Tuesday, November 26, 2002

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