 Hi, I am Dr. Nagbushan, I am a consultant intervention radiologist in Manipal Hospital Whitefield and Varthur. Uterine fibroids are non-cancerous swellings or lumps which are seen in uterine musculature. Around 70-80% of the women experience these uterine fibroids in some part of their life, but only 10-20% of them become symptomatic. The symptoms present as pain or heaviness in the lower abdomen especially. Some women experience irregular cycles, pain or more bleeding during menstrual cycles. When some fibroids are large, they compress on bladder causing increased sensation of passing urine. Symptoms rarely present as painful sexual intercourse. There are both medical and surgical treatments available for this condition. When the women are not relieved medically, then there are surgical methods such as hysterectomy which is done more commonly, which is complete removal of the uterus. Recent advances like laparoscopic myomectomy removes only the fibroid part, this is also done by gynecologist and the more recent technique is the uterine fibroid embolization where we intervention radiologists come into picture and this procedure has proven its benefit in this condition. The first and foremost advantage is the uterus is not removed in this procedure. So we are preserving the uterus which is very important for the women's physical and mental and reproductive well-being. Second is there is no scar or no suture on the body. So we are doing this with a small 2-3 mm pinhole incision. Third, there is very less hospital stay duration and fourth, there is faster recovery and the women can take up hard routine activities in a week's time. Yes, apart from routine blood investigations, we advise MRI contrast with pelvis. So this serves many advantages. First we can confirm the number, size and location of these fibroids. Second we can get an idea about the blood supply to these fibroids. Third, there are some mimicers of fibroids like focal adenomyosis and endometriosis. So these conditions can be ruled out better in MRI pelvis. And the last, sometimes MRI pelvis can detect a deep-seated infection or a possible tumor in the woman so that these conditions can also be addressed, not only stereotyping to the fibroid treatment. This procedure is done in angiographic suit. This is the place where angiograms and angioplasties are done for the heart. So when the patient is taken inside the angiographic suit, she will be given sedation by anesthesiologist. This ensures pain relief and sleep during the procedure. So in addition, we also give SHNB nerve block to ensure the pain relief. We gain access into the blood vessel near the right groin and enter uterine arteries both sides selectively. We inject polyvinyl alcohol particles which is needed for the treatment up to the end point is achieved. The patient is shifted back to the same ward and she is given a patient controlled analgesia pumps. When the patient experiences crampy abdominal pain, she can press on the button and the pain is relieved. So next day when we check on her, if the pain is completely relieved, she is fit for discharge or otherwise we can extend the stay for one more day. During discharge we advise antibiotics which is needed to prevent infection. We plan a second MRI after 6 months to compare the results. This procedure is effective for 6 long months. At the end of 6 months when we see comparing MRI scans, the uterine fibroids would have reduced for more than half in size. Not mere the size the symptoms will get better in 2-3 months time. For women who had irregular cycles, the first and second periods may be similar or more worse but from third cycle onwards the symptoms would start settling. Yes, pregnancy can be planned after the procedure. As I said earlier, this procedure will be effective till 6 months. We usually advise women to restrain from pregnancy for 6 months and later on the pregnancy can be planned. Whether it is a single or multiple fibroids, a single uterine fibroid embolization procedure addresses all the fibroids at once. No, this is a myth, there is no need of a hysterectomy after embolization procedure. Yes, we are a team of intervention radiologists and a Manipal Institute of Clinical and Intervention Radiology. We have 4 consultants with specialists and fellows. We cater services to all Manipal units. All the Manipal hospital units are equipped with state of the art angiography equipment so these procedures can be done very safe and effectively.