Management of uterine artery embolization for fibroids as an outpatient procedure

To evaluate whether it is safe to perform uterine artery embolization (UAE) as an outpatient procedure.

This retrospective study was approved by the institutional review board and included 234 patients (age range, 24-58 years; mean age, 40.5 years) who underwent UAE as an outpatient procedure with polyvinyl alcohol particles between January 2007 and March 2008. Patients were given acid-suppressing drugs, nonsteroidal anti-inflammatory drugs, anti-histaminic drugs, and laxatives twice on the day before UAE and once on the morning of UAE. Pain score, rated from 0 to 10, was evaluated by using a numeric pain scale during UAE, after the procedure, at discharge, at the night of discharge, and on the following morning. The outcome of UAE was evaluated at 6 months by means of pelvic magnetic resonance imaging and clinical observation.

The mean pain score was 0.9 during embolization, 2.5 4-8 hours after embolization, 0.9 at discharge, 1.1 the first night after discharge, and 0.7 the next morning. All patients were discharged from the hospital 4-8 hours after the procedure, with no overnight hospital admissions. At 6 months, 146 of 158 patients (92.4%) reported an improvement in menorrhagia, 39 of 44 (88.6%) reported an improvement in bulk symptoms, and 20 of 25 (80%) reported an improvement in pain. The volumes of the uterus and the dominant fibroid decreased 33.7% and 39.3%, respectively.

With acid-suppressing, anti-inflammatory, and anti-histaminic drugs started on the day before UAE, the procedure can be performed safely as an outpatient procedure.