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Prof Saim Yılmaz, MD
"Follow up after embolization should always be done with contrast MRI, not ultrasound"

What should I do and what should I not do after embolization?

After fibroid embolization, the patient will spend the first few days in our center. After the procedure, pressure is applied to the artery in the groin for a while, a bandage is applied to the groin and the patient is asked to stay in bed for 6 hours. In order for the patient to spend this period comfortably, a urinary catheter is usually placed beforehand. This catheter can be removed the next day or after the patient begins to walk. Symptoms such as pain, nausea, loss of appetite, weakness and fever (postembolization syndrome) may occur for a few days after embolization, and these symptoms are treated during your stay in our center. ​ ​


The next day, you can get up in the morning, go to the toilet, have breakfast and take short walks around the center. You can also take a bath and remove the tape on the groin after bathing. Sometimes there may be slight swelling and bruising at the puncture site in the groin, which may progress towards the vagina. This condition, which is caused by a small amount of blood leakage under the skin, is insignificant, does not require treatment and disappears completely in a few weeks. It will be beneficial for you to have a companion during your stay in the center. Generally, the rooms you will stay in are large enough and your companion will be able to stay with you. After embolization, in more than half of our patients, a pinkish, bloody discharge comes out from the vagina and the patient may think that her mensturation has begun. This discharge, which is due to changes in the inner surface of the uterus after embolization, is temporary and disappears in a few days.

Usually 2-3 days after embolization, your pain will be relieved and you will be able to continue your treatment at home. When you are discharged, we will tell you the medications you need to use, answer your questions and give you a paper about what to do next. After the treatment, you can reach us by phone, whats app or e-mail when necessary, and send a report or picture if necessary. After you go home, you will need to take the same drugs given intravenously in the hospital by mouth. Remember that oral drugs mix into the blood later and are slightly less effective than intravenous drugs. For this reason, some of our patients may have a slight increase in complaints after they leave our center. This is normal, you should not be alarmed and you should just increase the dose of your medication a little. ​ ​


After discharge, you should use the preventive antibiotic we prescribed for you for at least 3-5 days. In addition, you should take your "anti-inflammatory" drug in the appropriate dose until the box is finished, as it reduces the inflammation and accelerates healing as well as pain relief. If these drugs make your stomach upset, you can take a stomach-protectant in the morning on an empty stomach. If you have pain despite these medications, first use simple painkillers such as paracetamol. After going home, these drugs are sufficient for approximately 90% of our patients. If you have pain despite these drugs, you can apply to a health care provider and get an intravenous pain reliever. In such a case, it will make things easier for you to show the paper we have given you and your medical report to the doctor.

After fibroid embolization, the pain will decrease gradually, not suddenly. It may be helpful to put a hot water bag on your stomach along with pain relievers. In most patients, the pain goes away after a few days, but some patients may have a small amount of pain even after 7-10 days. After this time, the pain does not normally recur. If the pain relapses severely after it is completely gone, you should let us know. Because this pain may be a symptom of fibroid expulsion or the onset of infection. ​ ​


Six months after embolization, you should take a contrast-enhanced pelvic MRI and send the CD images to us. We will compare it with your MRI before embolization and give you information about how the fibroids have died and how much they have shrunk. If you wish, you can bring the CD in person and talk face to face and get information. Contrast-enhanced pelvic MRI is the only method to show whether or not the uterine fibroids are dead. Ultrasound does not show whether fibroids are alive or dead. We have had many patients who went to their obstetrician after embolization and thought that they were not treated because their fibroids were still seen on ultrasound. Therefore, if your obstetrician says that your fibroids are still in place, please do not be alarmed, remember that ultrasound is insufficient for this evaluation and send your MRI to us. Try to have your MRI film taken with a device with a power of at least 1.5 Tesla and by giving intravenous contrast media, remember that we cannot say whether the fibroids are alive or dead if intravenous contrast is not given.


Video: 5 reasons to prefer embolization in myoma, Prof Dr Saim Yılmaz


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