Uterine Fibroid Embolization (UFE)

What is uterine fibroid embolization (UFE)?

Uterine fibroid embolization is a minimally-invasive alternative to hysterectomy or myomectomy. Performed instead of major surgery, this procedure requires minimal or no hospital stay and a shorter recovery. In this procedure, blood supply to the fibroid tumors is blocked, making them shrink.

During UFE, a thin tube called a catheter is inserted through a blood vessel in the leg or wrist and guided by fluoroscopic (X-ray) images to the blood vessels that feed the fibroids of the uterus. Tiny particles are injected to stop blood flow to the fibroids. Once blood flow to the fibroids is blocked, patients return home while the fibroids shrink gradually over the next weeks and months. 

Uterine fibroid embolization is a very effective procedure with an approximate success rate of 85%. Most individuals who undergo the procedure have a dramatic improvement in their symptoms and a decrease in size of their uterine fibroids. If menstruation has been heavy, it will usually return to a more normal flow after UFE. Following embolization, fibroids starve and shrink in a manner not unlike the natural way fibroids shrink after menopause.

Fibroid embolization is a minimally invasive therapy that does not require surgery, decreasing hospital stay and recovery time. 

Three and nine month progress following uterine fibroid embolization. A remarkable decrease in the size of the uterine fibroid allows room for the bladder to expand and decreases pressure on the spine, dramatically improving the patient's symptoms.

When is UFE recommended?

The American college of Obstetrics and Gynecology (ACOG) recognizes UFE as a safe and effective treatment for fibroids. UFE is generally recommended to any individual who is symptomatic from her fibroids and who wishes to avoid surgery such as a hysterectomy.  

Unlike some fibroid treatments, UFE targets all fibroids in the uterus, and is effective for individuals with only a few fibroids as well as those who have many fibroids, regardless of fibroid size. Uterine embolization can also be used to treat a less common cause of heavy and painful cycles called adenomyosis. 

Infertility related to fibroids can be complicated; UFE may not be the preferred therapy for individuals with fibroids who desire future pregnancies. Also, individuals with fibroids in certain locations within the uterus may be better candidates for another treatment option such as surgical fibroid removal. Your interventional radiologist will discuss with you whether UFE is a good treatment option.

What should I expect following embolization?

There are no restrictions after the procedure. It typically takes a week to 10 days to recover from embolization. In the first few days, pelvic pain and pressure from the procedure can be significant. Fevers, chills, and decreased energy levels such as you would experience with a cold or flu are typical. You will be prescribed strong pain and anti-nausea medication for use at home. Some patients may want to recover overnight in the hospital to help control the pain with intravenous medication, many return home the day of the procedure. 

You will have phone numbers for our staff, so it will be easy to reach your physician if you have any questions or concerns in the days following the procedure.

The first cycle following the procedure will frequently be heavier with more discomfort than usual. Breakthrough bleeding in between menstrual cycles is common in the first few weeks. It typically takes three months for the benefits of the procedure to be appreciated, and the fibroids commonly continue to shrink for 6-9 months or longer. Approximately 85% of patients who undergo uterine artery embolization have dramatic improvement of their symptoms, while 5-10% may require repeat embolization or other procedures to improve their symptoms.

What are complications and risks of UFE?

Most complications are rare, and most can be treated. Risks include fibroid expulsion and injury or infection of the uterus requiring surgical removal. These risks are each 1% or less and should be thoroughly discussed with your interventional radiologist before consideration of treatment. If you are close to menopause, you may stop having your period altogether after UFE.

Will my health insurance cover uterine fibroid embolization?

Nearly all insurance companies including Medicaid will cover treatment of symptomatic fibroids. Our department will work with your insurance company to authorize coverage before the procedure is performed.

Are routine medications safe to take prior to UFE?

Routine medications are safe to take prior to UFE. Some medications, such as blood thinners, are best discontinued several days prior to the UFE procedure. Your interventional radiologist will review your medications at the time of the initial office visit and determine whether you need to discontinue any medications prior to UFE.

You should continue to take birth control bills or other hormonal treatment that might have been used to control your period. They may be discontinued after the procedure.

How do I prepare for UFE?

Generally there is no special preparation for UFE other than the following:

• No solid food or beverages (other than water) for at least 6 hours prior to the procedure
• You may drink water up to 2 hours prior to the procedure