Uterine fibroid embolization (UFE) is a
procedure done by a
radiologist. It blocks blood flow to
fibroids in the uterus. (It is also called uterine
women who are not planning a pregnancy in the future, UFE is a possible option
in place of surgery for fibroids.
Follow your doctor's instructions exactly about
when to stop eating and drinking, or your procedure may be canceled. If your
doctor has instructed you to take your medicines on the day of your procedure,
do so using only a sip of water. About an hour before the procedure,
you may be given a
sedative to help you relax. It will not put you to
sleep, because it is important that you be awake to follow instructions during
Uterine fibroids (leiomyomata) are non-cancerous growths that develop in or just outside a woman’s uterus (womb). Uterine fibroids develop from normal uterus muscle cells that start growing abnormally. As the cells grow, they form a benign tumor.
First, a thin, flexible tube called a catheter is
placed into a blood vessel in the upper thigh (femoral artery). A substance
called contrast material is then injected into the catheter. You may feel a
warming sensation as it travels up to the uterus. The radiologist uses
real-time X-ray on a video screen (fluoroscopy) to
see the arteries and then guides the catheter to the arteries that supply blood
to the fibroid. A solution of polyvinyl alcohol (PVA) particles is injected
into those uterine arteries through the catheter. These particles build up in
the targeted arteries and block blood flow to the fibroid.
Uterine Fibroids: Should I Have Uterine Fibroid Embolization?
What To Expect After Treatment
Uterine fibroid embolization usually
takes between 1 and 3 hours, depending on how long it takes to position the
catheter and how easy it is to position the catheter in the arteries in the
uterus. When the procedure is over, the catheter is removed and pressure is
applied to the puncture site for 10 to 15 minutes, unless there are problems
with bleeding. A bandage is then applied. You can expect to have at least 6
hours of bed rest after the procedure.
You may be sent home after
the bed rest period if your pain is under control, or you may spend the night
in the hospital for more observation or pain control. This will depend on your
radiologist's normal practice. And it will depend on how well you do after the
Moderate to severe pelvic pain is common for 6 to 12
hours after this procedure. A stay in the hospital and
narcotic pain medicine are used to control this pain,
if needed. You can also ask for antinausea medicine if you have nausea or
vomiting. Some women are able to control their pain with
nonsteroidal anti-inflammatory drugs, such as
ibuprofen or aspirin. Be safe with medicines. Read and follow all instructions on the label.
You may have some vaginal bleeding for a
couple of weeks. This is from a fibroid that is breaking down and bleeding.
In some cases, bleeding or pain persist for several months. Some
women also pass a fibroid from the vagina, usually 6 weeks to 3 months after
having UFE. This can happen even a year afterward. If you do pass fibroid tissue, see your doctor right away to be sure that you do
not develop infection or problem bleeding.
You should be able to return to your usual activities in 7 to 10 days.
Recommended follow-up care after UFE includes a checkup 1 to 3
weeks afterward and an
MRI 3 to 6 months later.
Why It Is Done
Uterine fibroid embolization is used
to shrink or destroy uterine fibroids. It is used in women with fibroid
problems who do not wish to treat fibroids with
hysterectomy, do not plan to be pregnant in the
future, and have not reached
menopause. Although there are no size limits, UFE is
not recommended for all types of fibroids.
If you are strongly
against ever having a hysterectomy, UFE may not be a reasonable option for you.
In some cases of infection or uterine damage, UFE has led to a need for a
How Well It Works
UFE is an
effective treatment, but fibroids may return.
Uterine fibroid embolization
reduces the size of fibroids an average of about 50%.1
Approximately 80 out of 100 women
treated with UFE for uterine fibroids report that their symptoms
UFE does not always cure fibroids. In one study, nearly 1 out of 5
women who had UFE had a repeat UFE or a hysterectomy within the next couple of years.2
The rate of complications after UFE is low but
Infection. This is the most serious,
potentially life-threatening complication of UFE. In rare cases, hysterectomy is needed to treat an infected uterus.
Premature menopause. This seems more likely to happen to women
over 40 years of age than in younger women.
Loss of menstrual
Scar tissue formation
Pain that lasts for months.
What To Think About
UFE may not be a good choice if you want to get pregnant. It's possible to get pregnant afterward,
but it's uncertain how good the odds are. This procedure does have a risk of damaging an ovary or the uterus,
which would make it much harder to get pregnant. There may be a higher risk for pregnancy problems.
For a uterine
fibroid embolization, be sure that you have a specially trained interventional radiologist who has a lot of experience with
Uterine fibroid embolization may be a good
treatment option for women who do not wish to receive
blood transfusions (which can be needed after
myomectomy) or who have other serious health
conditions that make
general anesthesia dangerous. UFE is not safe for
women who are allergic to contrast material (used for fluoroscopy during UFE).
UFE has several advantages over hysterectomy, myomectomy, and
treatment with GnRH-a (the hormone-suppressor medicine used to shrink
General anesthesia and an
abdominal (belly) incision are not required.
There is no blood loss, so there is no need for blood transfusions.
All fibroids may be
treated at the same time.
It does not cause bone-thinning (osteopenia) or
the other serious side effects associated with GnRH-a therapy.
Disadvantages of UFE include:
Cost. UFE is as expensive as
An unpredictable effect on fertility. It is not recommended for
women who hope to become pregnant.
The possibility of delayed
infection sometime in the first year, which can become life-threatening if not
Not being a sure cure. In one study, nearly 1 out of
5 women who had UFE had a repeat UFE or a hysterectomy.2
The possibility that some insurance plans will
not cover this procedure.