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September 18, 2020  
FIBROIDS1 NEWS: Feature Story

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  • Managing Short-Term Pain Associated with UFE

    Managing Short-Term Pain Associated with UFE

    December 05, 2005

    By: Jean Johnson for Fibroids1

    Any time the uterus is stimulated, cramping will occur since the walls of the organ are muscular. So women who undergo uterine fibroid embolization (UFE) – where circulatory specialists called interventional radiologists inject tiny plastic particles via a spaghetti-size catheter inserted in main artery of the groin to cut off blood supply to symptomatic fibroids – are bound to experience some short-term pain.
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    Fast facts from the Society of Interventional Radiology:

    Fibroid embolization usually requires a hospital stay of one night.

    Pain-killing medications and drugs that control swelling are typically prescribed after the procedure to treat cramping and pain.

    Many women resume light activities in a few days and return to normal activities within 7 to 10 days.

    Short term, because since the overall recovery time for minimally-invasive procedures like UFE is shorter than surgical treatment for fibroids by weeks and months, long-term outlooks are especially favorable. Most women are back to normal activity in two weeks or less after embolization, as compared to a month or more after myomectomy or hysterectomy. That said it is pain surrounding the procedure and its immediate aftermath that will be discussed.

    So what degree of pain do women commonly experience after having an embolization? Answers, of course, vary.

    For starters, a 1999 report from Britain indicated women having uterine fibroid embolization needed to expect serious pain. Once the catheter is in position and enough embolizing particles are released into uterine arteries to block blood flow to fibroids, “severe post-embolization pain,” wrote staff nurse at the department of radiology in Kent and Canterbury Hospital, Lioba Howatson-Jones, R.G.N., “…usually proportional to the volume of the tissue embolized” can occur.

    Howatson-Jones also notes that “how pain is tolerated depends in part on psychological and social influences” and she adds that anxiety associated with the procedure can elevate the perception of pain.

    By 2002, however, as embolization began coming into its own, news about pain from the American side of the Atlantic was less conclusive. Robert Vogelzang M.D., chief of interventional radiology at Northwestern Memorial and professor of radiology at Northwestern University Medical School, chastised some of the surgeons included in the study he led. “Several women were told in no uncertain terms that the procedure would result in severe pain for weeks,” said Vogelzang. “None of the women who had the procedure at our institution experienced that.”

    Most recently a recent interview for Fibroids1 Harjit Singh, M.D. and women’s health intervention specialist in embolization at the Hershey Medical Clinic in Pennsylvania put the record on a more even tone. “All patients experience post-embolization pain. We admit the patients to the interventional radiology service and place them on either a morphine or dilaudid pump for approximately 12 to 15 hours,” said Singh. “The patients are watched over night and discharged first thing in the morning.”

    Singh adds, however, that he’s only had to keep only one patient in six years for an extra 12 hours of pain control. “That patient experienced lesser degrees of pain at home, culminating in a wave of cramps on the third day,” he said. “I have not had any patients require narcotics at home, but I make it clear that is an option if they need it.”

    Singh’s first patient, Heidi Hormel didn’t have to take him up of the offer. In fact, the main pain issue Hormel associates with her 1999 uterine fibroid embolization was that of having to lay flat on her back without bending her knees. She has chronic lower back issues that were antagonized by that position.

    “I didn’t have pain associated with the procedure, but I have lower back problems and lying like you have to, completely flat with your legs straight out and not bent, my back really started hurting,” said Hormel. “Even once the procedure was over, you had to lay completely flat for four hours on the gurney and then another four hours of sitting up a little bit. They gave me a morphine drip, though so I used it for my back pain.”

    Hormel also says that once she was home, even though she’d heard that embolization could cause severe pain both at the hospital and after, and so was expecting problems, she had none. “It just was not bad,” said Hormel.

    From what we’ve been able to determine at Fibroids1, then, it seems that women opting for embolization need not anticipate any more pain than they might for any number of procedures geared toward relieving symptoms associated with fibroids. While there will always be exceptions, the rule seems to be that women who chose uterine fibroid embolization will not experience levels of short term pain that cannot be adequately controlled by pain medication – both in the hospital immediately after the procedure and at home while recuperating.

    Last updated: 05-Dec-05


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