Adenomyosis Embolization

Context and indications

Adenomyosis is a condition in which the tissue that normally lines the uterus (endometrium) grows into the uterine muscular wall. It causes heavy and painful periods, chronic pelvic pain and can impair fertility. Uterine artery embolization is a minimally invasive alternative to hysterectomy.

Benefits

Uterine preservation, significant symptom improvement (reduced bleeding and pain) in 70-85% of cases, rapid recovery (1-2 weeks), outpatient procedure.

Procedure

Under local anesthesia and sedation, a catheter is inserted through the radial (wrist) or femoral (groin) artery and guided successively into the right and left uterine arteries. Embolization microspheres are injected to reduce the blood supply to the adenomyotic tissue. The procedure takes 1 to 2 hours.

Risks

Post-embolization syndrome is common (pelvic pain, nausea, mild fever) for several days. Rare complications include uterine infection or permanent amenorrhea (especially after age 45). Impact on future fertility should be discussed on a case-by-case basis.

Follow-up

Overnight stay or outpatient. Pain management with analgesics. Follow-up MRI at 3-6 months to assess response. Symptoms improve progressively over 3 to 6 months.

Practical information

The procedure is performed under local anesthesia on an outpatient basis (same-day discharge).