Adenomyosis is a noncancerous condition in the uterus that can cause excessive bleeding and pelvic pain. While uncommon, adenomyosis occurs when the tissue that lines the uterus grows into the muscular wall of the uterus. Our interventional radiologists are experts in diagnosing and treating adenomyosis using minimally invasive techniques.
Why Adenomyosis Embolization is Performed
Although adenomyosis is noncancerous, it can cause heavy menstrual bleeding and severe cramps that prevent patients from feeling their best. Adenomyosis is often confused with uterine fibroids because the symptoms are similar, and it can be difficult to diagnose. However, misdiagnosis can lead to incorrect treatment. Our interventional radiologists have extensive experience in diagnosing and treating both fibroids and adenomyosis using advanced imaging techniques and embolization to relieve painful symptoms.
What to Expect During Adenomyosis Embolization
Adenomyosis embolization is performed by an interventional radiologist, typically in an outpatient setting. Instead of general anesthesia, you’ll be sedated through an intravenous (IV) line, which means you’ll be very drowsy for the procedure but you won’t experience pain.
Next, local anesthesia will be used to numb the area of the artery at the top of your leg. Your interventional radiologist will make a pinhole-sized incision and insert a small catheter, or thin plastic tube. Advanced imaging, such as X-rays, will guide the catheter to the uterine artery.
Next, your interventional radiologist will inject a dye that helps to make the arteries more clear. Once the uterine artery is confirmed, your doctor will inject embolizing particles through the catheter and into the artery. This creates a blockage of blood flow, causing the cells to atrophy, or die.
After the procedure is complete, the catheter is removed and the small incision site is bandaged. Adenomyosis embolization is usually finished within a few hours. Many patients go home the morning after the procedure.
Risk and Benefits of Adenomyosis Embolization
Adenomyosis embolization is a tolerable procedure that is effective at improving the pain, pressure, and bleeding that can accompany adenomyosis. As with any procedure, there can be complications. Though rare, these may include:
- Uterine infection
- Artery damage (from the catheter insertion)
- Blood clots
- Damage to the ovaries or uterus
Women may be concerned about longer-term effects of X-rays on the quality of their eggs if they are planning to have children. The radiation exposure during the procedure is low, but women should discuss their concerns with their provider.
How to Prepare for Adenomyosis Embolization
Before your adenomyosis embolization procedure, you will meet with your interventional radiologist who will help you prepare. Be sure to tell your interventional radiologist about all current medications, as you may need to stop taking blood thinners or other drugs prior to your procedure. Your care team will let you know when you need to stop eating solid foods and drinking before your adenomyosis embolization.
Since adenomyosis embolization requires sedation, be sure to arrange transportation for after the procedure.
Post Adenomyosis Embolization
After your procedure, you may experience pelvic cramps for several hours. Your doctor can prescribe pain medication, if necessary. About 80-85% of patients who undergo adenomyosis embolization will experience substantial improvement or complete relief of symptoms within two to three months.
Adenomyosis embolization may lead to menstrual changes. For some women, monthly bleeding is much lighter or stops altogether. For others, the first post-procedure menstrual cycle may have heavier flow with more pain than usual, but both issues should resolve over time. Women experiencing ongoing heavy bleeding should contact their physician for a follow-up exam.