UTERINE FIBROID EMBOLIZATION (UFE) – Recovery
It is common for us to hear from our patients that the recovery after UFE is often the most difficult part of the entire experience surrounding this procedure. Following UFE, patients return to the Radiology Observation Area, where they recover with our nursing staff for at least 4-6 hours. During that time, most patients experience pain and nausea due to the effects of the procedure.
The pain and cramping after this procedure can range in severity from very mild to quite severe. This pain is most likely due to the effect that the procedure has on both the fibroids and the normal uterus. Immediately after the procedure, IV medication is given for pain relief and is effective at increasing the comfort of our patients. The medications we use for pain control include an opioid analgesic or narcotic (such as Morphine) as well as a non-steroidal anti-inflammatory agent called Toradol, which is similar to Ibuprofen. Depending on the degree of discomfort, these medications are given either upon request to our nursing staff or on-demand by a patient-controlled device. As a result of these medications and the medications given for sedation during the procedure, most patients are drowsy for several hours after the procedure.
Nausea can cause a great deal of discomfort to our patients after this procedure and is due to both the effect of the procedure on the fibroid and to the medications given to our patients for pain relief. We have found that this side effect of the procedure can typically be controlled with medication given prior to the start of the procedure.
After 4-6 hours, a discharge plan is established for each patient with input from our physicians, our nursing staff, and the patient and her family. An inpatient observation bed is reserved for every patient undergoing UFE but a decision as to whether or not a patient will stay overnight is made at this time. Patients who are anxious about home recovery, patients travelling a significant distance to get to Albany, or patients requiring large doses of medication for pain relief are all observed overnight. Currently, most of our patients stay overnight after UFE. The remaining patients elect home recovery and many of patients relate to us that the ability to recover at home is one of the main reasons why they selected UFE to treat their fibroids.
Antibiotics and pain medication are supplied to patients upon discharge with a detailed schedule as to when to take each medication. Once discharged, they are taken home by a family member. Bed rest is recommended for the first evening. The next day, patients move on to limited activity around their home without any heavy lifting or exercise. The recovery period and the way patients feel during the recovery period have varied greatly among the women that we have treated. Normal activity is permitted two days after the procedure. However, an individual patient’s activity will be limited by the degree of pelvic cramping and nausea experienced during the recovery period. After two days, individual tolerance for activity is the best indicator of what a patient can and cannot do.
During the first 5 days after discharge, most patients experience additional episodes of pain during the first 5 days. This can catch some patients by surprise as it frequently occurs after 1-2 relatively pain-free days. We therefore recommend that patients follow our pain medication schedule for at least 3-4 days so that they are not caught “off-guard” by these episodes. As the pain improves, narcotics are discontinued and patients are maintained on over-the-counter medications such as ibuprofen. Most of our patients have been able to return to work within 10 days of the procedure. We do recommend that patients abstain from sexual intercourse for at least 2 weeks after the procedure or until any post-procedure discharge they may have been experiencing has stopped.