Managing Postembolization Syndrome–Related Pain after Uterine Fibroid Embolization

Uterine fibroids are the most common neoplasm affecting women, occurring in more than 70% of women prior to menopause. Of that 70%, 25% have symptoms severe enough to warrant treatment.[1] Symptoms range from abnormal uterine bleeding, bulk symptoms with urinary and bowel incontinence, dyspareunia, infertility, and debilitating chronic pain.[2]

Since its introduction in 1995, uterine artery embolization (UAE) has evolved into a well-established, safe, and effective minimally invasive, uterine-sparing procedure for the treatment of symptomatic uterine fibroids.[3] [4] [5] Annually, greater than 25,000 UAE procedures are performed worldwide.[6] Despite its successes, a persistent challenge and impediment to more widespread use of UAE has been management of postprocedure pain as a result of postembolization syndrome (PES). Inadequate pain control is the most common indication for admission and readmission.[7] Predicting the degree of PES is challenging. The range of severity may vary based on intrinsic patient factors, fibroid size and location, imaging characteristics, or preprocedural symptoms.[8] New techniques and pain regimens can be applied to manage symptoms and significantly improve patient satisfaction.

The objective of this review is to discuss pain management options after UAE by summarizing the current available literature.

Publication History

Article published online:
10 August 2021

• References

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