Uterine Fibroid Embolization: Uterine Fibroid Treatment without Surgery
What is Uterine Fibroid Embolization?
Uterine fibroids are non-cancerous growths in the uterus that affect up to 80% of women by age 50. For many women, they cause heavy periods, pelvic pressure, frequent urination, and back pain that interferes with daily life. Depending on location and patient preference, fibroids can be treated several different ways, including hysterectomy (surgical removal of the uterus), myomectomy (laparoscopic or hysteroscopic surgical resection of the fibroids), or uterine fibroid embolization (UFE).
Uterine fibroid embolization is a nonsurgical procedure performed through a small pinhole incision in the wrist or groin where an interventional radiologist guides a microscopic catheter into the small arteries supplying the fibroids using live X-ray guidance. Once there, the interventional radiologist injects microscopic particles into the uterine vessels to slow blood flow to the fibroids. The uterus is spared and over several months, the fibroids both shrink in size and bleed significantly less.
What are the benefits of uterine fibroid embolization?
The UFE procedure offers a nonsurgical option to patients who may want to preserve their uterus or who may not be a candidate for surgery. Unlike surgery, the benefits of the UFE surgery include a faster recovery and no general anesthesia. Many patients return to work in one to two weeks with no limitations. The embolization procedure can impact future fertility, so it is important to discuss your desire for pregnancy with your provider before you elect for the procedure. The procedure is effective in 90% of patients and takes two to six months to see the full effects. In the small minority of patients where this procedure may not be effective, we coordinate with our gynecology colleagues to ensure you get the care you need.
Who is a candidate for a uterine fibroid embolization?
UFE is appropriate for most women with symptomatic uterine fibroids or adenomyosis who want to avoid surgery or preserve their uterus. You may be a good candidate if you have:
• Heavy or prolonged menstrual bleeding (soaking pads within an hour, bleeding that lasts more than seven days, or transfusions).
• Pelvic pressure or a feeling of fullness in your lower abdomen.
• Frequent urination or difficulty emptying your bladder completely.
• Lower back pain or pain during intercourse.
• An enlarged abdomen that feels like a pregnancy.
• Iron-deficiency anemia from heavy bleeding.
You may not be a candidate for UFE if you:
• Have a known or suspected pregnancy.
• Have an active pelvic infection.
• Have a diagnosed or suspected gynecologic malignancy.
• Have a serious contrast allergy.
• Have postmenopausal bleeding (must get endometrial biopsy first).
Surgery may be a better option if you have:
• Intracavitary fibroids (UFE if hysteroscopy fails).
• Large subserosal fibroids (myomectomy).
• Broad ligament fibroids.
• Cervical fibroids.
The best way to know if UFE is right for you is to schedule a consultation with one of our interventional radiologists. They will review your imaging, discuss your symptoms, and walk you through all of your options.
What to Expect: Your UFE Journey
Step 1: Initial Consultation
You will meet with an interventional radiologist who specializes in UFE. They will discuss your symptoms and your candidacy and obtain an MRI to characterize your fibroids. This visit typically takes 45–60 minutes and may be done virtually if you prefer.
Step 2: Follow-Up Visit
You’ll meet with your doctor to discuss the results of the MRI and to see if you are a suitable candidate for the UFE procedure. If you are, they will walk you through the procedure and partner with you to discuss what options work best for you. This visit will take 30 minutes and may also be done virtually.
Step 3: The Procedure (about 90 minutes)
UFE is performed in our interventional suite under conscious sedation—you are not put to sleep, but these medications will relax you and certainly help you fall asleep. A small catheter is inserted through a tiny nick in your wrist or upper thigh. Using X-ray guidance, the interventional radiologist navigates the catheter into the uterine arteries and injects tiny particles that block blood flow to the fibroids.
Step 4: Recovery (1–2 weeks)
You will be admitted for one night to make sure you are comfortable. You may experience cramping, flu-like symptoms, and nausea for 24–72 hours, which we manage with medication. Most women return to light activity within a few days and full activity within seven to 10 days. A team member from our office will reach out in two weeks to check in with you.
Step 5: Results (3–6 months)
Fibroids typically shrink up to 80% in three to six months and heavy bleeding usually resolves in two months. Pelvic pressure and urinary symptoms improve as fibroids shrink. Your first period after the procedure may be heavier than usual and you may have some irregular bleeding for one to two months. Over 90% of patients report significant improvement in symptoms.
Frequently Asked Questions
Q: Does insurance cover UFE?
Yes. UFE is covered by Medicare, Medicaid, and most commercial insurance plans when fibroids are symptomatic. Our team will verify your benefits before your appointment.
Q: Is UFE painful?
The procedure itself is performed under conscious sedation, so you are comfortable during the procedure. Afterward, most patients experience cramping for 24–72 hours that we manage with pain medication. This is normal and is called post-embolization syndrome.
Q: Will UFE affect my fertility?
UFE is generally considered a uterus-preserving procedure, and many women have conceived after UFE. However, if pregnancy is a priority for you, we recommend discussing your full range of options with one of our interventional radiologists and your OB/GYN.
Q: How is this different from what my OB/GYN does?
Your OB/GYN is an expert in the uterus and reproductive health and can offer surgical solutions to fibroids. The uterine fibroid embolization is a nonsurgical procedure performed by a vascular and interventional radiologist—a specialist trained in navigating the blood vessels using image guidance. Together, we work as a team to provide the most appropriate solution for your fibroids.
Q: Do I need a referral to see an IR?
No, you can directly schedule an appointment with one of our interventional radiologists by calling 609-537-6440.