Complications following UFE
All medical procedures carry risks of complications. One of our jobs as your physician is to decide if the benefits of a procedure outweigh the risks to a given patient. The following complications are presented in roughly the order of expected frequency, with the most common complications first and the least likely last
Pain
Every woman who goes through UFE needs to expect to experience pain. However, the amount of pain caused by UFE has been dramatically reduced with modifications of our techniques and with the introduction of a nerve block during the procedure. During the procedure you are getting medications in your IV that will help you feel relaxed and take away pain, but the procedure is not the painful part. I will give you a long acting anesthetic during the procedure that blocks pain from your pelvis; this nerve block is so effective at stopping the pain that most of my patients are able to go home 2 hours after UFE and half of them never require narcotic pain medicine. The majority of the pain caused by UFE goes away within about 12 hours, and that is about how long the nerve block lasts. If you begin to feel uncomfortable as the block wears off you will have pain medicines with you that you can take as needed.
Temporary ovarian dysfunction
The ovaries are stunned by UFE. Ovarian function decreases briefly for most women who have the procedure but usually rebounds after a month or so. During that time you may experience some menopausal symptoms such as hot flashes.
Expulsion of tissueIf a fibroid is in the endometrial cavity or even just close to the endometrial cavity it can lose its attachment to the uterus as pass out through your cervix and vagina. When this happens to a small fibroid it can go unnoticed. Even large fibroids may break up into tiny fragments that come out with your period like clots. But larger fragments may cause cramping as they pass as your cervix dilates to expel them.
Menopause
Sometimes the ovarian dysfunction is permanent, and you go into menopause. Women who are less than 45 years of age have a 5% chance of going into menopause after UFE. Women who are over 45 years of age have a 15% chance of going into menopause. You may say that is fine with you and not care if you ever have another period, but we are not trying to put you into menopause and consider it a complication if it happens.
Persistent pain at puncture site; leg numbness; bruise at puncture site.
These sensations usually go away after the first day but can persist for several weeks. If you get a bruise it may take a couple of weeks to go away.
UTI or bladder irritation
Some women will have bladder discomfort or pain with urination after UFE. If we use a catheter to drain your bladder your risk of this happening increases. Sometimes it is an actual infection, other times it is just inflammation due to the procedure or bladder catheter. We will treat you with either antibiotics or antispasmodics as needed.
Allergic reaction to one of the medications we give you
While we will ask you about known allergies and avoid those medicines it is always possible that you could be allergic to one of the medications we use and you dont know about it. If it happens we are prepared to treat you.
Allergic-like reaction to X-ray contrast
Very rare using modern contrast but if it happens we are prepared to treat you.
Complications that could result in your needing to have a hysterectomy
All of these are rare or very rare, occurring less than 1% of the time: an infection in your uterus that fails to respond to antibiotics; pelvic pain that persists rather than resolving after the first day or first week; being unable to pass a fibroid that sloughs.
Blood clots
Any patient who is relatively immobile after a procedure or surgery is at risk for developing blood clots in her leg veins. To prevent this we place compression hose on your legs and, if you spend the night in the hospital, use devices the periodically squeeze your calves to keep the blood moving.
Bowel Obstruction
Extremely rare following UFE (remember that the most common cause of bowel obstruction in a woman is prior hysterectomy)
The following have never occurred in our UFE practice:
Non-target embolization
This happens when the particles we put into the artery to embolize it wind up in another artery and damage the tissues supplied by that artery. All of my experience that I bring to the table for you is to prevent this from happening. It is extremely unlikely to occur.
Death
Yep, as with any medical procedure death is always on the list of possible complications.
Every woman who goes through UFE needs to expect to experience pain. However, the amount of pain caused by UFE has been dramatically reduced with modifications of our techniques and with the introduction of a nerve block during the procedure. During the procedure you are getting medications in your IV that will help you feel relaxed and take away pain, but the procedure is not the painful part. I will give you a long acting anesthetic during the procedure that blocks pain from your pelvis; this nerve block is so effective at stopping the pain that most of my patients are able to go home 2 hours after UFE and half of them never require narcotic pain medicine. The majority of the pain caused by UFE goes away within about 12 hours, and that is about how long the nerve block lasts. If you begin to feel uncomfortable as the block wears off you will have pain medicines with you that you can take as needed.
Temporary ovarian dysfunction
The ovaries are stunned by UFE. Ovarian function decreases briefly for most women who have the procedure but usually rebounds after a month or so. During that time you may experience some menopausal symptoms such as hot flashes.
Expulsion of tissueIf a fibroid is in the endometrial cavity or even just close to the endometrial cavity it can lose its attachment to the uterus as pass out through your cervix and vagina. When this happens to a small fibroid it can go unnoticed. Even large fibroids may break up into tiny fragments that come out with your period like clots. But larger fragments may cause cramping as they pass as your cervix dilates to expel them.
Menopause
Sometimes the ovarian dysfunction is permanent, and you go into menopause. Women who are less than 45 years of age have a 5% chance of going into menopause after UFE. Women who are over 45 years of age have a 15% chance of going into menopause. You may say that is fine with you and not care if you ever have another period, but we are not trying to put you into menopause and consider it a complication if it happens.
Persistent pain at puncture site; leg numbness; bruise at puncture site.
These sensations usually go away after the first day but can persist for several weeks. If you get a bruise it may take a couple of weeks to go away.
UTI or bladder irritation
Some women will have bladder discomfort or pain with urination after UFE. If we use a catheter to drain your bladder your risk of this happening increases. Sometimes it is an actual infection, other times it is just inflammation due to the procedure or bladder catheter. We will treat you with either antibiotics or antispasmodics as needed.
Allergic reaction to one of the medications we give you
While we will ask you about known allergies and avoid those medicines it is always possible that you could be allergic to one of the medications we use and you dont know about it. If it happens we are prepared to treat you.
Allergic-like reaction to X-ray contrast
Very rare using modern contrast but if it happens we are prepared to treat you.
Complications that could result in your needing to have a hysterectomy
All of these are rare or very rare, occurring less than 1% of the time: an infection in your uterus that fails to respond to antibiotics; pelvic pain that persists rather than resolving after the first day or first week; being unable to pass a fibroid that sloughs.
Blood clots
Any patient who is relatively immobile after a procedure or surgery is at risk for developing blood clots in her leg veins. To prevent this we place compression hose on your legs and, if you spend the night in the hospital, use devices the periodically squeeze your calves to keep the blood moving.
Bowel Obstruction
Extremely rare following UFE (remember that the most common cause of bowel obstruction in a woman is prior hysterectomy)
The following have never occurred in our UFE practice:
Non-target embolization
This happens when the particles we put into the artery to embolize it wind up in another artery and damage the tissues supplied by that artery. All of my experience that I bring to the table for you is to prevent this from happening. It is extremely unlikely to occur.
Death
Yep, as with any medical procedure death is always on the list of possible complications.