Uterine Artery Embolisation
What is Embolisation?
Embolisation is a minimally invasive process of causing an organ or tumour to reduce in size by blocking its blood supply. This can be achieved using a number of different materials such as small foam particles, metal coils, glue or, as in the case of fibroid embolisation, polyvinyl alcohol (PVA) particles specially designed for the purpose. Interventional radiologists performing the procedure have years of experience of embolisation in other parts of the body for problems such as cancerous growths or to stop bleeding following trauma or childbirth. Uterine fibroid embolisation applies these skills and techniques in the context of uterine fibroids.
Uterine Artery Embolisation for Fibroids
Uterine artery embolisation is now a well established treatment for uterine fibroids, one of the commonest gynaecological problems that can lead problems such as heavy periods that interfere with daily acitivites, period pain and pressure symptoms.
Dr. Crowe and his teams at the Priory Hospital in Birmingham and at Birmingham Heartlands Hospital have been offering UAE for over twenty years and he has performed over 7000 fibroid embolisations. He has been the leading individual contributor to the UK Fibroid Embolisation Registry run by the British Society of Interventional Radiology.
As each case is unique you should consider any information on this site in conjunction with your gynaecologist’s advice. You can download a patient information booklet and contact Dr. Crowe to make an appointment to discuss your individual situation in more detail.
What is Uterine artery embolisation?
Uterine artery embolisation (UAE), also known as Uterine fibroid embolisation (UFE) is a procedure which aims to shrink the fibroids by blocking their blood supply. Dr. Crowe was one of the first interventional radiologists to offer embolisation treatment in the UK, starting a service at Birmingham Heartlands Hospital in the year 2000.
UAE is a minimally invasive procedure that is usually done under local anaesthetic with a little sedation and which entails a single night stay in hospital with a short recovery period and rapid return to normal activities.
Referral and Booking
You may have been referred to Dr. Crowe by your GP or gynaecologist who will have performed an examination and possibly arranged imaging tests such as an ultrasound or MRI scan. Many women, however, make enquiries having done their own research on the treatment options available.
If you are not currently under the care of a gynaecologist Dr. Crowe can recommend one of his gynaecology colleagues.
Dr. Crowe first meets you in the out-patient department to discuss the procedure and answer any questions you may have. It is useful to have an MRI scan beforehand so all the required clinical information is available for discussion at the time of the consultation.
The day of the procedure
The hospital will send you full information regarding arrival time and fasting on the morning of the procedure. You will be admitted to the ward where you will be clerked in by the nursing staff. A pregnancy test is routinely performed prior to the procedure. It is also routine to insert a bladder catheter. This is for your own comfort as you will need to lie flat for several hours afterwards.
The embolisation procedure itself is usually painless but pain can occur afterwards when the arteries have been blocked and spasm occurs. Medication is given at the start of the procedure aiming to prevent pain. A PCA (patient controlled analgesia) pump is used which runs through a small drip and allows you to give yourself small doses of morphine as required for a few hours after the procedure. The advantage of a PCA pump is that you are in complete control and can use as much or as little as you need to control any pain you may have.
Afterwards
Following the embolisation procedure you will be taken back to your room where you will be looked after by nursing staff familiar with looking after embolisation patients. You will need to lie flat for a few hours to reduce the risk of bleeding from the puncture site in the groins. You will have the morphine pump to control any pain and the nursing staff can give medication to relieve any nausea caused by the morphine.
A one night hospital stay is the norm and you should be ready to go home late morning the day after the procedure.You can return to normal activities almost immediately but may experience some fatigue and crampy pain (like period pain) for up to a few weeks. You should not drive for 48 hours and it is advisable to book 7 – 10 days off work.
Pregnancy after UAE
The official UK guidelines from the Royal College of Radiologists and Royal College of Obstetricians and Gynaecologists Joint Working Party (November 2000) recommended that women undergoing uterine fibroid embolisation should be advised not to try and conceive due to theoretical adverse effects on the embryo. These early recommendations were perhaps over-cautious and it is recognised that many women choose embolisation as an alternative to hysterectomy in order to preserve fertility and keep their options open. It is not, however, advisable to become pregnant within 12 months of the procedure as the fibroids are still breaking down.
Next steps
Please contact Dr. Crowe’s secretary on 0121 448 1502. Procedures are performed at The Priory Hospital and the Harborne Hospital in Birmingham and at the Princess Grace Hospital in London.
Most private insurance companies now cover the procedure and for non-insured patients the individual hospital can offer a competitive all in price. Note that hospital charges in central London are generally higher than in Birmingham Please get in touch for more information.
Uterine Artery Embolisation for Adenomyosis
In uterine artery embolisation for adenomyosis, the procedure is essentially the same as at that for uterine fibroids. When embolisation is being performed for adenomyosis it is usual to use a slightly smaller particle size for the embolisation as this has been shown to give a better result. There is a higher recurrence rate of adenomyosis post embolisation than is the case with uterine fibroids and it is occasionally necessary to repeat the embolisation procedure a few years down the line. For women closer to menopause, however, this is not usually a problem.
If you wish to consider Uterine Artery Embolisation treatment please read the Fibroid Embolisation Patient Information booklet.
Private Medical Insurance
Dr. Crowe is recognised by all the major private health insurance providers. To avail of your private insurance cover it is essential to contact your insurer in advance and obtain the necessary pre-authorisation for treatment. Dr. Crowe’s office can provide his provider number for the insurance company concerned as well as the procedure codes for the proposed treatment. Having this information before contacting your insurer speeds up the process of getting pre-authorisation.
While Dr. Crowe’s professional fees are within the insurance companies’ published guideline ranges the level of cover will depend on the conditions of your individual policy or that provided by your employer and cover should always be checked in advance. Some policies may stipulate an excess to be paid by the policy holder and this may be invoiced to you directly. There may be annual limits on cover, limits on out-patient cover or restricted cover for pre-existing conditions. Certain policies may also limit the choice of hospitals where treatment can be provided and this is particularly the case when considering treatment in central London. Insurers may stipulate that you must be referred to Dr. Crowe by your general practitioner or specialist but some allow self-referral or provide their own online GP service.
Self pay
It is not necessary to have private health insurance to avail of private medical care. More and more people are choosing to self-fund private treatment and are finding costs are often less than they had anticipated. Private medical care offers prompt and efficient diagnosis and treatment with your choice of consultant, at a time that suits you, in a clean and pleasant hospital environment.
Upon request price quotes can be obtained for the various treatments offered by Dr. Crowe. Having an initial consultation and scan does not commit you to proceeding with treatment and for more expensive high tech procedures the individual private hospitals can often offer a range of payment options. Although Dr. Crowe’s professional fees are standard regardless of treatment site the total costs are usually lower in Birmingham, reflecting higher hospital and clinic charges in central London.
For diagnostic scans Dr. Crowe can offer ultrasound, CT and MRI scanning at very reasonable self-fund rates that also vary from one private hospital to another. Plain X-Rays required for immigration and pre-employment health screening purposes can also be arranged.
Overseas Patients
Dr. Crowe is happy to take overseas referrals and can offer telephone and online consultations. Scans performed in your home country can be reviewed and he can liaise with your local doctors before you travel. Advice can be given on travel and follow up arrangements.
The private hospitals where Dr. Crowe practices can quote all in prices for treatment and assist with booking and arrangements prior to travel.
Dr. Crowe is recognised by many international and expatriate health insurance providers. In other cases the private hospitals may have agreements with international insurers and can facilitate treatment planning by liaising directly with the insurer for price quotes and invoicing.
Dr Crowe is based in London and Birmingham. Birmingham is the second largest city in the UK and is situated approximately 100 miles (160Km) north of London. There are excellent road and rail links and Birmingham International Airport provides direct flights to most European destinations as well as direct links to American, Asian and Middle Eastern cites.