Fibroids are non-cancerous growths that occur on the walls of a woman’s uterus. Fibroids are common in premenopausal women and often cause no significant symptoms. However, depending on how large a fibroid is and where it is located, pain and heavy bleeding may become too much for some women to deal with and, in rare cases, the fibroid can lead to problems with fertility. For those seeking relief, uterine fibroid embolization (UFE) is a minimally invasive treatment that blocks the blood flow to the fibroid to shrink it over time.
Why uterine fibroid embolization is performed
Few women with fibroids elect to undergo treatment. However, when physical symptoms are significant and a woman’s gynecological provider recommends treatment, UFE is often the procedure of choice.
UFE is a safe and well-tolerated procedure performed by an interventional radiologist. More than 80% of patients have success with UFE for alleviating their symptom, addressing issues such as:
Heavy menstrual periods that can lead to anemia
Pain in the pelvis area or up and down the backs of the legs
Pain during sexual intercourse
Abdominal pressure that can result in frequent urination, constipation, and bloating
What to expect during uterine fibroid embolization
UFE is performed under conscious sedation. The interventional radiologist locates the patient’s femoral artery in her leg and numbs the area with local anesthesia. A needle is used to create a pathway for a catheter (thin plastic tube) to be threaded through the artery to reach the uterine artery. X-ray guidance with contrast dye (to improve image quality) helps the physician clearly see veins and bloodflow during UFE, which improves precision and safety.
Once the uterine artery is accessed, the embolization process begins. Tiny particles are slowly released through the catheter and into the artery. The grain-sized particles flow directly to the fibroid, inserting themselves in its blood vessels. This creates a blockage of blood flow to the fibroid, causing the cells to atrophy, or die.
Risks and benefits of uterine fibroid embolization
UFE is a tolerable procedure that is effective at improving the pain, pressure, and bleeding that can accompany a fibroid. As with any procedure, there can be complications. Though rare, these may include:
Artery damage (from the catheter insertion)
Damage to the ovaries or uterus
Women may be concerned about longer-term effects of x-rays on the quality of their eggs if they are planning to have children. The radiation exposure during the procedure is low, but women should discuss their concerns with their provider.
How to prepare for uterine fibroid embolization
The care team will talk with the patient about current medications and identify any medications that will need to be paused prior to the embolization. Patients will also be instructed on when to stop eating and drinking ahead of the scheduled procedure. Most women have an overnight hospital stay for observation and go home the following day, and should plan accordingly.
Post uterine fibroid embolization
Pelvic cramps are common immediately following a UFE. Pain medicine will be given during the in-hospital recovery period. These cramps may be strong at times and last for up to two weeks.
UFE often leads to menstrual changes. For some women, monthly bleeding is much lighter or stops altogether. For others, the first post-procedure menstrual cycle may have heavier flow with more pain than usual, but both issues should resolve over time.
As the embolization works and the fibroid starts to atrophy, some patients will experience passing the actual fibroid tissue, depending on the size and location of the growth. Women experiencing ongoing heavy bleeding should contact their physician for a follow-up exam.
Most women feel fully recovered within two weeks after UFE. The majority will experience improved symptoms in the months following the embolization, as the fibroid growth shrinks. Fibroids may return in a small percentage of patients. In those cases, a repeat procedure may be recommended.
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