What is Uterine Artery Embolisation (UAE)?
Uterine Artery Embolisation (UAE) is a minimally invasive interventional radiology procedure that treats symptomatic uterine fibroids (leiomyomata) without surgery. Tiny embolic microspheres are injected via a catheter into the uterine arteries blocking blood flow to fibroids and starving them of their blood supply. Fibroids then undergo infarction and shrink progressively over 3–6 months, leading to significant symptom relief in 85–90% of patients. The uterus is preserved, no surgical incision is made, and recovery is dramatically faster than hysterectomy.
Who is This Procedure For?
Uterine artery embolisation (UAE) is suitable for pre-menopausal women with symptomatic uterine fibroids who wish to preserve their uterus or avoid the risks and recovery associated with surgery. It is most commonly indicated for heavy menstrual bleeding (menorrhagia), which can lead to anaemia, fatigue, and a reduced quality of life. UAE is also effective in managing pelvic pressure and bulk-related symptoms caused by large fibroids pressing on surrounding organs, leading to urinary frequency, constipation, or a sensation of pelvic heaviness and discomfort. Women experiencing painful periods (dysmenorrhoea) due to fibroid-related uterine contractions often see significant improvement after the procedure. It is a preferred option for those who wish to avoid surgery, including women who decline hysterectomy or myomectomy, or those at high surgical risk due to anaemia, medical comorbidities, or prior abdominal surgery. Additionally, UAE is beneficial for women with multiple fibroids located in different areas, where surgical removal would be extensive, as well as for those with recurrent fibroids after previous myomectomy, since UAE can treat all fibroids simultaneously regardless of their number or position.
How is UAE Performed?
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Pre-procedure MRI Pelvis
Pelvic MRI characterises fibroid number, size, position (submucosal, intramural, subserosal), and vascularity essential for treatment planning and outcome prediction.
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Femoral Artery Access
Under local anaesthesia, a small catheter is inserted through the right femoral artery in the groin. Pelvic angiography maps the uterine arterial anatomy.
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Right Uterine Artery Embolisation
Microcatheter is advanced superselectively into the right uterine artery. PVA microspheres (500–700 microns) are injected slowly until flow is significantly reduced.
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Left Uterine Artery Embolisation
Catheter is repositioned to the left uterine artery via the same femoral access and the procedure is repeated both uterine arteries are treated in one session.
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Post-UAE Analgesia & Monitoring
IV analgesia manages post-embolisation syndrome (pelvic cramping, low-grade fever). Discharged in 1–2 days. Follow-up MRI at 3–6 months assesses fibroid shrinkage.