Uterine Fibroid Embolization in Lucknow

Fibroids are non-cancerous growths in the muscle wall of the womb. They are common in women of reproductive age, and many cause no symptoms at all. A fibroid that causes no trouble usually needs only watching.

When fibroids do cause symptoms, the usual ones are heavy or long periods, which can lead to anaemia, pelvic pain or a feeling of pressure, backache, needing to pass urine often, and constipation. Large fibroids can make the lower abdomen look swollen.

Treatment is considered when symptoms affect daily life, work or health. The options include medicines to reduce bleeding, hormonal treatment, surgery to remove only the fibroids (myomectomy), removal of the womb (hysterectomy), and UFE.

UFE cuts off the blood supply to the fibroids so that they shrink over time. An interventional radiologist passes a thin tube, called a catheter, into an artery, usually at the wrist or groin. Using live imaging, the catheter is guided into the uterine arteries, which supply the womb.

Tiny particles are then released into the small branches feeding the fibroids. They lodge there and block the flow. Normal womb muscle has a wider blood supply and generally copes. The fibroids lose their blood supply and shrink over the following weeks to months.

No cut on the abdomen is needed and the womb stays in place.

UFE may be considered for a woman with symptomatic fibroids who would like to avoid surgery, keep her womb, or who is not well suited to an operation. The gynaecologist and the interventional radiologist decide together.

Future pregnancy is the most important question. Evidence on pregnancy after UFE is more limited than after myomectomy. Pregnancies have occurred after UFE, but its effect on fertility and on pregnancy is less certain. If you hope to have a child, discuss this first with your gynaecologist.

UFE is not done during pregnancy or when there is an active pelvic infection. It is also not suitable if the heavy bleeding has another cause, or if a cancer of the womb is suspected, which is why the cause must be established first.

A gynaecological ultrasound shows the number, size and position of fibroids, the thickness of the womb lining and the ovaries. A transvaginal scan, where a small probe is placed in the vagina, gives closer detail. It also helps the doctors judge whether your symptoms are likely to come from fibroids.

Before UFE, most teams also want a detailed MRI of the pelvis to plan the procedure and to check for other conditions. We do not have an MRI scanner. Your gynaecologist or the procedure team advises where to get it done, and we can review the images and reports.

Blood tests, including haemoglobin if periods are heavy, are usually checked too. Sometimes a smear test or a sample from the womb lining is needed as well.

At our centre, the team reviews your referral, scans and reports first. After that review, it confirms whether the procedure is carried out at the centre or elsewhere, and by whom. Suitability is confirmed for each woman.

The hope is lighter periods and less pressure as the fibroids shrink. This does not happen for everyone, and some women need further treatment later.

Risks to be aware of include:

• Pain afterwards: cramping in the lower abdomen is common in the first day or two and is treated with medicines.
• Post-embolization symptoms: a low fever, tiredness, nausea and a vaginal discharge for days to a couple of weeks.
• Infection of the womb, which is uncommon but serious.
• Fibroid tissue passing through the vagina, which sometimes needs a procedure.
• Effects on periods and the ovaries: periods may change or stop earlier than expected, particularly in older women.
• Hysterectomy: rarely, removal of the womb becomes necessary afterwards because of serious infection or bleeding.
• Dye and puncture site: an allergic reaction to the dye, kidney strain, bruising or artery damage where the catheter went in.
• Radiation: the procedure uses live imaging with a small dose of radiation, so tell the team if you could be pregnant.

Your gynaecologist can tell you which options fit your symptoms, age and plans. This table is a general guide only.