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Referring Doctor’s Guide for Uterine Fibroid Embolization

UFE Protocol and Patient Referral Information by Dr Eisen Liang

Potential candidates are patients with the following symptoms:

  1. Severe menorrhagia (with or without anemia) 
  2. Bulk related symptoms referable to compression of the bladder or ureter. 
  3. Chronic pelvic, back, or leg pain or discomfort that can be attributed to the fibroids

Pre-Procedure Gynecologic Evaluation:

  1. Each patient should have a pelvic examination by her gynecologist within six months of the procedure.
  2. A Pap smear within the last year and should be normal.
  3. For patients with abnormal uterine bleeding (periods lasting longer than 10 days or periods more frequently than every 21 days), an endometrial biopsy should be done, preferably within the preceding 3 to 6 months. This is to be certain that endometrial carcinoma or hyperplasia is not present. Endometrial biopsy can be arranged at the time of the interventonal radiology consultation.
  4. If the patient has a history of pelvic infection, cultures for Gonorrhea and Chlamydia should be obtained.

Pre-Procedure Radiology Evaluation:

  1. All patients will be required to have a pre-procedure consultation by the interventional radiologists. This allows us to obtain a gynecologic and general medical history, a brief physical examination, and to review the imaging findings and to discuss the procedure with the patient. 
  2. The patient must not be pregnant. A pregnancy test is needed if the procedure is done more than 14 days after the beginning of the patient's most recent menstrual cycle. 
  3. Full blood count and FSH will be obtained on the day of the procedure. If the patient has a history of renal disease or coagulation defect, further laboratory testing may be required. 
  4. An MRI of the pelvis is preferred. We prefer that this be done at SAN Radiology or Gosford hospital to ensure uniformity of imaging.

Follow-Up Protocol

After the procedure, follow-up visits occurs at 1 week and at 3, 6, 12 and 24 months with the interventional radiologist. A follow-up MRI is performed at 6months. Patients are instructed to continue all their normal gynecologic care with their referring gynecologist and/or GP. Patients’ GP and gynecologist will be sent letters to update them on the patient's imaging and symptom status.

For more information

If you would like to refer a patient, please ask your secretary or the patient to call 9487 9840 (SAN) or 4320 2336 (Gosford) to make an appointment for a pre-procedural consultation with Dr Eisen Liang.

If you would like to discuss further with Dr Liang, please call 9487 9840 or e-mail eisenliang@gmail.com