Uterine Fibroid Embolization
Fibroids are benign tumors made up of muscular and fibrous tissue that develop from the smooth muscle cells of the uterus. Fibroids can be microscopic in size or grow as large as a cantaloupe, but they very rarely become cancerous. Fibroids are most common in women between the ages of 30 and 50, and one in four women will be diagnosed with fibroids during her reproductive years.
While some women with fibroids have no symptoms, others can develop excessive bleeding, pain, pressure on the bladder and bowel, and a loss of fertility.
What is uterine fibroid embolization?
Uterine Fibroid Embolization (UFE)—a minimally invasive, safe, and highly effective treatment for uterine fibroids—is one of the alternatives to hysterectomy (complete removal of the uterus). During this procedure an interventional radiologist—a doctor who uses imaging techniques and long, flexible, thin tubes called catheters and other micro-tools—will treat your fibroid by navigating these tools to the arteries that supply fibroids with blood, and filling these vessels with an “embolic agent” (FDA approved polyacrylamide microspheres with a gelatin coating). The agent blocks blood from reaching the fibroid, and once its blood supply is eliminated fibroids shrink, generally to about half their original volume. Studies have shown that nearly 90 percent of women who undergo UFE experience significant or complete resolution of their fibroid-related symptoms.
How do I get ready for the test?
After midnight on the evening before your procedure you should not eat or drink anything. Your doctor will tell you which medications you may take in the morning.
What will happen during the test?
After you arrive in one of our outpatient offices and are ready for the procedure, we will administer a local anesthetic to numb your groin area, then insert a needle into the femoral artery, a large artery in the thigh. This needle provides access for a catheter, which we will guide to the uterine artery up to the point where it divides into multiple vessels that supply blood to the fibroids. Your doctor will use an X-ray technique called fluoroscopy to guide the catheter into position.
Once the catheter is in place we will inject a contrast dye into the artery, which enables us to see the blood supply to the fibroids. After this procedure, called an arteriogram, we will slowly inject an embolic (blocking) agent (synthetic particles the size of grains of sand) into the artery through the catheter. The embolic agent flows with the blood toward the fibroids and becomes wedged in the vessels supplying the fibroids with blood. We will continue the procedure for several minutes until the blood flow is completely blocked. Blood flow will continue to other parts of the uterus.
We routinely perform UFE in under an hour, and you will then recover in your own private room. Most patients return to work in under a week.
Are there any risks?
The procedure is relatively safe. Major complications include:
Post-embolization syndrome consisting of pain and a low grade fever
Premature Ammenorrhea: some women no longer have menstrual periods after UFE. This is unusual in women under 35.
Endometritis: infection of the lining of the uterus. This rarely occurs and can be successfully treated with antibiotics in most cases.
Please discuss all risks and benefits with an interventional radiologist during your consultation
After the test
Most UFE patients are scheduled as the first case of the day in our outpatient office and recover in their own private room, going home in the late afternoon. You will likely need about four days at home to recover, and most patients feel back to normal after a week to 10 days.
Most women experience 6 to 12 hours of severe cramping after UFE. We usually treat your pain with an oral or intravenous painkiller while you're in the hospital. The pain usually decreases during the first week and can be controlled with an oral painkiller.
During the first week after UFE you might experience side effects including fever, fatigue, nausea, cramps, and abdominal pain.
We will schedule a follow-up appointment for you within a week to a month after the procedure, and we may order imaging tests to check the status of the fibroids 3-6 months after the procedure.