Giving my uterus a 42 year service! (Uterine Artery Embolization)

Member Name: spankygoodtime

Product:	Uterine Artery Embolization
Date:	07/01/02 (1053 review reads)
Rating:

Advantages: Avoids having to have a hysterectomy because of fibroids.

Disadvantages: Can be hard to get on the NHS.

Fibroids are benign tumours that can occur in the muscle wall of the uterus. They are very common and can be present in the uterus of a woman of any age, although they are more usual in older women. These growths can vary considerably in size from being similar to that of a pea, to being as large as a watermelon. Some women may only have one, but others might have many fibroids of various sizes. It is possible for a woman to go through life unaware that she has fibroids, as they can give no problems at all. However the symptoms associated with fibroids described below, can ruin quality of life for others.

~~ Fibroid complications ~~

The most distressing of all for many women is infertility. Miscarriages can also be associated with fibroids.

Heavy, painful periods. In some cases a woman may bleed continuously throughout her cycle. Although I am personally not that unlucky, my five or so days of menstruation really have been a nightmare in recent years. I work in busy professional kitchens and it is embarrassing to have to run for the loo every half -hour, despite wearing maximum absorbency tampons and a sanitary towel as backup. Fibroids can also cause heavy clotting that increases the pain associated with menstruation. The size of these clots can be very frightening, as I know only too well.

Pressure on nearby internal organs can cause damage if the fibroid is very large. Incontinence or difficulty in passing water can result from a fibroid pressing on the bladder. The common symptom of fibroids that I have, is constant nagging stomach pains or backache. This is making it very uncomfortable for me to stand for any length of time, so I know that if I do nothing I will be unable to continue working as a chef.

Large fibroids can result in a bloated feeling and cause the stomach to stick out. I find it confidence eroding to stand sideways on to a mirror!

~~ Some fibroid treatments ~~

Hysterectomy: One
of the most common reasons for a hysterectomy is because of the presence of fibroids. This major operation involves the removal of the uterus although the ovaries and cervix may be left if this surgery is necessary just because of fibroids. The major drawback of a hysterectomy is the loss of fertility in women of childbearing age. Even if the ovaries are left, a surgical menopause may still be bought about by this operation. It is necessary to take at least 6 weeks off work after a hysterectomy and a woman will require help and support from her family or social services.

Myomectomy: This operation involves cutting the fibroids out of the uterus via an incision made in the stomach. The danger of this is in the bleeding that can occur during this type of surgery. This may result in an emergency hysterectomy to save a woman’s life. As with a hysterectomy, a woman will need to take at least 6 weeks off work and will be dependent on others for help. This operation can also be a waste of time as the fibroids will grow back in some cases.

Drugs: Drugs can be prescribed that will alleviate the symptoms of fibroids. These drugs can also aid shrinkage of fibroids and are sometimes prescribed to reduce the bulk of the uterus prior to surgery. The drawback of these drugs is that as soon as a woman stops taking them, the fibroids and the symptoms associated with them return. They can also cause menopausal symptoms and loss of bone density, therefore they are unsafe for use over a long period of time.

Mirena Coil: this Intrauterine Contraceptive Device (IUD) is of course normally fitted to avoid pregnancy. However it has been found that a side affect of using the Mirena Coil is periods are much lighter. Sometimes this device will be the solution for woman with small fibroids.

Diet and alternative therapies: Diet can help problems associated with fibroids. By cutting down consumption of fat, dairy foods, red meat, caffeine, alcohol, s
ugar and salt, I have made my symptoms easier to live with. On a long basis this is a miserable way to live. I love food!!!

Some women have resorted to acupuncture or herbal remedies to treat their fibroids. Although bleeding and pain can be sometimes be alleviated, this kind of treatment does not treat the cause of the problem, as the fibroids won’t go away. You need money to try alternative therapies and you need time to find a reputable practitioner. It is sometimes possible to take this route via the NHS depending on what you wish to try.

~~ Uterine Artery Embolisation. ~~

Uterine fibroids tend to develop with their own supplying blood vessels. These are connected with the arteries that supply the uterus, which allows the fibroids to also receive blood and oxygen, so they flourish. Uterine Artery Embolisation (UAE) is performed by a specialist radiologist, using a special x-ray machine connected to a monitor. This procedure involves obstructing the blood vessels connected to the fibroid thus starving it of blood and oxygen. A local anaesthetic and some sedation is given, and then a catheter is inserted into the femoral artery via a small nick cut in the skin crease of the groin. This tube is then guided up to the uterine artery and a dye injected to enable the radiologist to identify the fibroid blood supply. Once these blood vessels have been identified, thousands of tiny particles of a plastic like material (Polyvinyl alcohol) are injected into these veins via the catheter. This has the effect of silting them up.

This causes the fibroid to shrink and die. In some cases it will slowly break up and be expelled via the vagina or even come out whole. Other women will find that this treatment may shrink their fibroids considerably and alleviate the discomfort associated with them.

This treatment is not invasive, so the recovery time is much quicker. As no incision is made there is no ugly operation scar. Fibro
ids treated by UAE have not been found to grow back. If you have UAE you will probably only need to take a fortnight off work, some women are able to return to work sooner than this.

The biggest disadvantage connected with this treatment is that the scarring that may result from fibroids sloughing off. This can leave a woman unable to have children. I was warned by my gynaecologist not to consider UAE unless I was sure that I could live with this consequence. However in the research I have done, I have read of pregnancies in women that have had this treatment.

Occasionally an infection can develop after UAE, which will mean that a hysterectomy will have to be carried out. I was told that there was a 1% chance of this happening.

~~ My personal experiences of UAE ~~

I had an exploratory operation last March. This simply enabled the surgeon to have a look inside my uterus to see why I had been having heavy periods and pain. When I came round I was told that I had a very large fibroid and that the only solution was a hysterectomy. I was told that I would be given an appointment to see a gynaecologist to discuss this fairly quickly. This verdict filled me with horror and I asked for a few months to think about it. I had vaguely heard of UAE so I researched it on the Internet and decided to ask if I was suitable for this procedure.

When I saw my gynaecologist UAE was not mentioned to me as a solution to my problems. However when I asked about it she was very positive about trying it and promised to look into the possibilities for me.

A couple of months later I received a letter and information from a consultant radiologist at Guy’s Hospital who specialises in UAE. Approximately 300 women have been treated by this method here. As my gynaecologist had said that I needed to go to someone that has performed this procedure a lot of times, I agreed with her choice of consultant/hospital. After I had discussed my
worries and concerns by email I was given an appointment.

On the day of arrival I was checked over by a Doctor before changing into the usual hospital gown and being taken on a trolley to radiology. I was given a suppository containing pain-killing drugs that would be slowly absorbed over the next 10 hours or so. I was told this had to be inserted in my rectum and I was allowed to do this myself in the ladies toilet, although the nurse said she would do it for me if I was unhappy or unsure about doing this. I also had to provide a urine sample for pregnancy testing.

Once this test showed negative the consultant radiologist came to go through what was going to happen to me and I signed the consent form. I was then wheeled into a special x-ray room where I was transferred to a x-ray machine connected up to a computer monitor.

I felt a small scratch when the local anaesthetic was administered and some pressure when the catheter was pushed into my groin. I was able to see what was happening on the computer monitor and it was an interesting experience to be able to see the dye going up through the veins feeding my fibroid. This procedure seemed to be over very quickly although I had been told that it normally lasts around 45 minutes. I was under sedation so this probably helped the time go fast. I had no discomfort or pain at any time although I can remember complaining of feeling sick at one point.

Once the procedure was completed the catheter was removed from my groin, which resulted in a little bleeding. I was instructed to lie still for a while before being taken out to recover. I had been warned to expect anything from moderate to severe pain after UAE and I did have bad stomach pains by this time, which felt like the worst period that I have ever had. I would not however describe the pain as severe. I was given an injection to alleviate this pain and was also allowed a patient controlled morphine pump.

After being t
aken back to my room, I spent the afternoon drifting in and out of sleep entertained by a succession of strange dreams. My sister visited me in the afternoon and tells me that I was absolutely whizzing! I did not feel any pain at all due to the morphine, but the unfortunate side affect of morphine is it can make you very sick and giddy as I found out. I was given an injection in the backside to counteract the nausea. Oddly enough the pain from this jab was the worst that I had all day. After an overnight stay I was well enough to be allowed home in the afternoon of the next day.

I was off work for two weeks, and although I had been told to expect some abdominal pain, and given drugs to counteract this, I felt nothing. Although it is too early to say if this operation has been of benefit to me, I would do it all again rather than rush into a hysterectomy.

I will update this opinion as and when there is something to tell. If you have fibroids and need help, advice or pointers to information mail me. The most important tip I have is, if you want to try this treatment for fibroids on the NHS, then you need to ask your gynaecologist if your case (not all are) might be suitable for treatment by this method. He or she may not necessarily suggest it to you. Secondly you need to see a consultant radiologist who has done UAE a lot of times.

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