Copyright © 2020 JoVE Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License jove.com September 2020 • 163 • e61530 • Page 1 of 44 The Lublin Protocol of the Uterine Arteries Embolization in the Treatment of Symptomatic Uterine Fibroids Piotr Szkodziak *,1 , Krzysztof Pyra *,2 , Filip Szkodziak 1 , Jarosław Krzyżanowski 1 , Piotr Czuczwar 1 , Sławomir Woźniak 1 , Tomasz Jargiełło 2 , Tomasz Paszkowski 1 1 3rd Chair and Department of Gynecology, Medical University of Lublin 2 Department of Interventional Radiology and Neuroradiology, Medical University of Lublin * These authors contributed equally Corresponding Author Piotr Szkodziak piotr.szkodziak@gmail.com Citation Szkodziak, P., Pyra, K., Szkodziak, F., Krzyżanowski, J., Czuczwar, P., Woźniak, S., Jargiełło, T., Paszkowski, T. The Lublin Protocol of the Uterine Arteries Embolization in the Treatment of Symptomatic Uterine Fibroids. J. Vis. Exp. (163), e61530, doi:10.3791/61530 (2020). Date Published September 15, 2020 DOI 10.3791/61530 URL jove.com/video/61530 Abstract Uterine fibroids are benign tumors originating from smooth muscle tissue, constituting uterine muscle stroma. Uterine fibroids are the most common benign tumors found in women. In 20%–50% of women, fibroids are asymptomatic and do not require any treatment. The main symptoms of uterine fibroids are profuse menstrual bleeding, abnormal uterine bleeding, and pressure symptoms. Pressure symptoms can cause pelvic pain syndrome, urination disorders, and constipation. The treatment methods that are currently used include surgical treatment, pharmacological therapy, and minimally invasive procedures. The most commonly applied minimally invasive method is the embolization of uterine arteries. This procedure is currently a widely accepted method of treatment for symptomatic uterine fibroids and has been recognized as such by the National Institute for Health and Clinical Excellence in the guidelines for heavy menstrual bleeding. This is a complicated procedure and requires close cooperation between gynecologists and interventional radiologists. We present a protocol applicable to uterine artery embolization in the treatment of symptomatic uterine fibroids. The protocol is divided into five section. The first two section are intended for gynecologists and interventional radiologists, explaining how to qualify and prepare a patient for embolization in a step-by-step manner. Section three, which is directed at interventional radiologists, explains how embolization should be done. Section four is directed at gynecologists or hospital ward doctors who look after the patients after embolization. This section of the protocol offers a method for treating post- embolization pain using the Patient Controlled Analgesia (PCA) pump. Section five completes the procedure with an assessment of the effects and late complications of uterine artery embolization.