Uterine Fibroid Embolization (UFE)
Uterine Fibroid Embolization (UFE) is a minimally invasive procedure to treat fibroids—the most common noncancerous uterine tumors. While fibroids do not always cause symptoms, their size and location can lead to pelvic pain and heavy bleeding. Until recently, hysterectomy (removal of the uterus) was the only treatment for fibroids. Today UFE is largely successful in shrinking fibroids and, thus, treating fibroid pain.
Minimally invasive. Minimal recovery.
Between 25% and 40% of women age 35 and older have uterine fibroids of significant size. African-American women are at higher risk for fibroids, with as many as 50% reporting fibroids of significant size. Fortunately, our team of fellowship-trained vascular and interventional radiologists have extensive experience in the evaluation and treatment of uterine fibroids. We’ve helped hundreds of women with this proven, minimally invasive therapy. If you suffer from uterine fibroids, we urge you to consider UFE before scheduling a hysterectomy. After all, hysterectomy is major abdominal surgery with a weeks-long recovery. Schedule a consultation with Eastern Radiologists Interventional Radiology to find out if you’re a candidate for UFE.
Frequently Asked Questions
Depending on the location, size and number of fibroids, they may cause:
- Heavy, prolonged menstrual periods and unusual monthly bleeding, sometimes with clots (this often leads to anemia)
- Pelvic pain
- Pelvic pressure or heaviness
- Pain in the back or legs
- Pain during sexual intercourse
- Bladder pressure leading to a constant urge to urinate
- Pressure on the bowel, leading to constipation with bloating
- Abnormally large abdomen
Fibroids are usually diagnosed during a gynecologic internal examination. Your doctor will conduct a pelvic exam to feel if your uterus is enlarged. The presence of fibroids is confirmed by a painless diagnostic test—most commonly an abdominal ultrasound, but sometimes magnetic resonance imaging (MR) or computed tomography (CT) are performed. Appropriate treatment depends on the size and location of the fibroids, as well as the severity of symptoms.
Most fibroids do not cause symptoms and are not treated. When they do cause symptoms, drug therapy is often the first step in the treatment. In many patients, symptoms are controlled with these drug treatments and no other treatment is required. Some hormone therapies do have side effects and other risks when used long term, so temporary use is preferred; however, fibroids often enlarge after therapy is discontinued. The next step is to try more invasive therapy. The traditional treatment for fibroids is hysterectomy (surgical removal of the uterus). Less invasive procedures have been developed which are better tolerated by patients, including myomectomy and UFE. Myomectomy is a surgical procedure that removes fibroids from the uterine wall. Preservation of fertility is a potential benefit of these less invasive alternatives.
UFE is a minimally invasive procedure. The patient is given medicine through an IV, which relaxes and relieves pain during the procedure. UFE is performed by an interventional radiologist, who makes a small nick in the skin (less than one-half of an inch) in the groin and inserts a catheter into an artery. The catheter is guided through the artery to the uterus while the interventional radiologist watches the progress of the procedure using fluoroscopy. Tiny plastic particles the size of grains of sand are then injected into the artery that supplies blood to the fibroid tumor. This cuts off the blood flow and causes the tumor (or tumors) to shrink. The artery on the other side of the uterus is then treated.
Fibroid embolization usually requires an overnight hospital stay. Medications are prescribed following the procedure to treat cramping and pain, which are common side effects. Fever is an occasional side effect and is usually treated with acetaminophen. Many women resume light activities in a few days, and the majority are able to return to normal activities within a week.
Studies show that between eight to nine out of 10 patients who have the procedure experience significant or total relief of heavy bleeding, pain and other symptoms. The procedure also is effective for multiple fibroids, and recurrence of treated fibroids is rare.
All procedures, even minimally invasive ones have the potential for complications. UFE is considered to be very safe. However, there are some associated risks, as there are with any medical procedure. Most women experience moderate to severe pain and cramping in the first several hours following the procedure. Some experience nausea and fever. These symptoms can be controlled with appropriate medications. A small number of patients have experienced infection, which can usually be controlled with antibiotics. Also, it has been reported that there is a 1% chance of injury to the uterus, potentially leading to hysterectomy. A small number of patients have entered into menopause after embolization. This is more likely to occur in women in their mid-40s or older and already nearing menopause.
A recent study comparing the fertility of women who had undergone UFE and women who opted for myomectomy showed similar numbers of successful pregnancies for both groups; however, this study has not yet been confirmed by other investigators, and the long-term effects of UFE on the ability of women to have children have not been fully determined.
Interventional radiologists are specially trained physicians who use small catheters, stents and other minimally invasive devices, while watching their progress on X-ray or other imaging equipment, to diagnose and treat conditions. Typically, the interventional radiologist performs procedures through a very small nick in the skin. Interventional radiology treatments are generally better tolerated than surgery because they involve no surgical incisions, less pain and shorter hospital stays. Your interventional radiologist will work closely with your primary care physician or gynecologist to be sure you receive the best possible care.
Schedule an Appointment
Please have your doctor schedule your appointment for this service. If you have questions about your appointment or need to reschedule call 252.752.5000. This service is offered at the following locations:
Preparing for your appointment
*Bring all of your medications to your appointment.
The night before your procedure, refrain from eating or drinking after. If you’re taking medications, ask your doctor if you should stop taking them before or after the procedure.