Uterine fibroid embolization, sometimes known as uterine artery embolization, involves the blockage of the arteries supplying blood to the fibroids, effectively reducing their size, which reduces the seriousness of the symptoms. Unlike the other forms of treatment for symptomatic fibroids, only a localized anesthetic and sedative are used. With the use of a fluoroscope, a live action x-ray machine, a small catheter is inserted through the femoral artery, which is then followed to the uterine artery, and thus to the blood supply of the fibroids. Tiny particles are then injected into the arterial capillaries, effectively blocking the flow of blood, and nutrients, to the fibroids. Then the catheter is removed from the artery and the procedure is complete.
Fibroids are benign (non-cancerous) tumors of muscle that develop in the wall of the uterus. Fibroids are extremely common, occurring in up to one-third of all women. Most fibroids are small and asymptomatic and are, therefore, never detected. Fibroids can, however, lead to problems for some women including heavy menstrual bleeding (menorrhagia), pelvic pain, pelvic pressure, back pain, constipation and changes in urinary habits.Uterine fibroid embolization (also known as UFE or uterine artery embolization) is a relatively new, minimally-invasive, non-surgical treatment option for many women with uterine fibroid tumors.
Fibroid tumors can occur in several different locations within the uterus and are often multiple (See image). Submucosal fibroids are fibroids that grow and bulge into the inner lining (the endometrial cavity) of the uterus. These fibroids are most often associated with heavy menstrual bleeding and infertility issues. Intramural fibroids occur within the muscular wall of the uterus and are completely surrounded by normal uterine tissue. Subserosal fibroids develop on the outside of the uterus. Pedunculated fibroids are attached to the uterus by stalk. The symptoms caused by fibroids can vary significantly depending on the size, number and location of the fibroid tumors. These factors may also affect the best treatment options available to a patient with fibroids.
Am I a good candidate?
Most patients with symptomatic fibroids are candidates for UFE. Our interventional radiologists will determine whether or not you are a good candidate based on your clinical history and imaging findings, which may include an MRI.
Patients are generally admitted overnight to monitor for side effects and for management of pain within the first 24 hours following the procedure. Soreness that tapers off over the week following the procedure is common. This is due to the fibroids reacting to the lack of blood and nutrients, not due to infection. There are some general guidelines to follow after the procedure, which are; Limited activity for 24 hours following the procedure, after you have been released from the hospital stay. Generally, you should increase activity every day following the procedure. Do not try and lift more than 10 lbs. for one week after the procedure. Medication given for pain afterwards should be taken when needed or by instruction. Normal activity can resume as quickly as two days after the fibroid embolization. You can typically return to work one week after the procedure. Recovery time varies from patient to patient.
Patients must have a clear pap smear within the last 12 months. Consult with your primary care physician about the benefits of Uterine Fibroid Embolization. Some insurance carriers will require a referral from your primary care physician.
Uterine Fibroid Embolization is an alternative to hysterectomy for the treatment of uterine fibroids.
- Hysterectomy = 4-6 weeks recovery time: major surgery
- UFE = 5-7 days recovery time: small (1cm) incision in the groin
Although a small percentage of patients are still able to get pregnant following a UFE procedure, patients wanting to have children in the future may not be a candidate for this procedure.
Uterine Fibroid Embolization is recommended by the American College of Obstetrics and Gynecology as a non-surgical alternative to hysterectomy.