Uterine Artery Embolization: Risks and Recovery Insights

Questions related to uterine artery embolization?

Dear Dr.
Wang,
I underwent a uterine surgery earlier this year, but experienced severe postoperative hemorrhaging.
The hospital urgently performed a 4-hour uterine artery embolization procedure to control the bleeding.
I have a few questions that I hope you can help clarify for me.
Thank you for taking the time to respond!
1.
I had bilateral uterine artery embolization.
What is the total radiation dose I was exposed to? What potential harm could this radiation dose cause to my body?
2.
On one side, medication was administered for hemostasis, while a metal coil was placed in the other artery.
Are there any side effects associated with this permanently implanted metal coil?
3.
I frequently experience dull pain in my lower abdomen after the procedure.
Is this a common sequela of uterine artery embolization? How can I alleviate this discomfort?
Thank you for your kind responses, and I wish you success in your work and good health!
Wen-Chen

Wen-Chen, 50~59 year old female. Ask Date: 2018/11/22

Dr. Wang Yifen reply Radiology

Hello,
1.
The radiation exposure dose during uterine artery embolization can vary depending on the patient's body type and the duration of radiation exposure.
Literature (Acta Radiol.
2006 Mar;47(2):179-85) reports an average dose of approximately 32 millisieverts.
The purpose of performing uterine artery embolization to control hemorrhage after uterine surgery is to "save lives." In cases of postoperative hemorrhage, the primary consideration is the immediate risk to life, making the risks associated with radiation exposure relatively insignificant in comparison.
For information on the health effects of ionizing radiation, you can refer to the Atomic Energy Commission's website at https://www.aec.gov.tw/webpage/radtown/default.php.
2.
The metallic coils used in embolization are medical devices, and potential side effects include infection, coil displacement, and peripheral vascular occlusion.
These side effects are rare but may occur within 1-2 weeks post-procedure.
3.
After abdominal surgery and uterine artery embolization, patients may initially experience lower abdominal pain as a side effect; however, this typically resolves within 1-2 weeks.
If there is persistent lower abdominal discomfort after six months, it is advisable to consult a gynecologist for evaluation of potential causes.
I hope this information is helpful to you.
Wishing you safety and good health.

Reply Date: 2018/11/22

More Info

Hello Wen-Chen,
Thank you for reaching out with your questions regarding your recent uterine artery embolization (UAE) procedure. I appreciate your concerns, and I will address each of your questions in detail.

1. Radiation Dose and Potential Harm: During a uterine artery embolization, fluoroscopy is typically used, which involves exposure to ionizing radiation. The exact radiation dose can vary based on the complexity of the procedure and the duration of fluoroscopy. On average, the radiation dose for such procedures can range from 1 to 5 Gray (Gy). While this level of radiation is generally considered safe for diagnostic and therapeutic procedures, excessive exposure can increase the risk of radiation-induced effects, such as skin burns or, in rare cases, radiation-induced cancer over a lifetime. However, the benefits of the procedure, particularly in controlling severe bleeding, usually outweigh these risks. Your medical team would have taken precautions to minimize your exposure.

2. Permanent Metal Coil and Side Effects: The metal coils used in embolization are designed to be biocompatible and are generally well-tolerated by the body. They are intended to remain in place permanently to prevent blood flow to the targeted area, effectively stopping the bleeding. Most patients do not experience significant side effects from these coils. However, there can be rare complications, such as migration of the coil, infection, or tissue reaction. It’s essential to follow up with your healthcare provider for regular check-ups to monitor for any potential issues.

3. Post-Procedure Abdominal Discomfort: Experiencing lower abdominal discomfort after UAE is relatively common and can be attributed to several factors, including inflammation, the body’s healing response, or the presence of the coils. This discomfort can vary in intensity and duration. To alleviate this pain, your doctor may recommend over-the-counter pain relief medications, such as acetaminophen or ibuprofen, unless contraindicated. Additionally, applying heat to the abdomen or engaging in gentle physical activity may help ease discomfort. If the pain persists or worsens, it’s crucial to contact your healthcare provider to rule out any complications, such as infection or other issues.

In summary, while uterine artery embolization is a highly effective procedure for managing severe bleeding, it does come with some risks and potential side effects. It’s essential to maintain open communication with your healthcare team regarding any concerns or symptoms you experience post-procedure. They can provide personalized advice and interventions based on your specific situation.

Thank you for your thoughtful questions, and I wish you a smooth recovery and good health moving forward!
Best regards,
Doctor Q&A Teams

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