What is uterine artery embolization?
Uterine artery embolization, also known as uterine fibroid embolization or UFE, is a minimally invasive procedure used to treat uterine fibroids. Uterine fibroids are noncancerous growths in the uterus that can cause pain, heavy menstrual bleeding and place pressure on the bladder or bowel. During a uterine artery embolization, your doctor will use a catheter to inject particles into the uterine arteries in order to block the vessels — causing the fibroids to shrink and eventually die.
Research shows that close to 90 percent of women who have a uterine artery embolization experience relief from their symptoms.
Who is a candidate for uterine artery embolization
You may be a candidate for uterine fibroid embolization if you:
- Are in perimenopause
- Experience heavy bleeding and pain related to fibroids
- Are not a candidate for surgery or surgical procedures are risky for you
- Want to keep your uterus
Uterine artery embolization should not be performed for those patients who:
- Are pregnant
- Are diagnosed with pelvic cancer or other cancers
- Have an active chronic pelvic infection
- Have vascular disease
- Are allergic to iodine (used in the procedure contrast material)
- Have extremely large fibroids
Benefits of uterine artery embolization
For the right patient, uterine artery embolization is a safe an effective procedure. Benefits of having a uterine artery embolization instead of surgery include:
- UFE is less invasive than open or laparoscopic surgery
- A surgical incision is not needed to perform the procedure
- Most patients can resume their day-to-day activities earlier than with traditional surgery
- The procedure is performed under local, not general anesthesia, so recovery time is quicker
- There is minimal if any blood loss
- Most women treated with UFE, approximately 90 percent, experience complete or significant fibroid-related symptom relief
- Fibroids rarely regrow, and new fibroids rarely grow after UFE
Risks of uterine artery embolization
There are a variety of risks associated with uterine artery embolization. Risks are reduced when the procedure is performed by an experienced doctor.
Risks may include:
- Complications associated with placing a catheter into the blood vessel such as bleeding at the puncture site, infection and/or blood vessel damage.
- The embolic agent can lodge in the wrong location, causing the death of normal tissue.
- Allergic reaction to the contrast material used during the procedure.
- Passing fibroid tissue after uterine artery embolization. If this occurs, you will need to have a dilatation and curettage (D&C).
- It is rare, but women may enter early menopause after a uterine artery embolization. This is most common in women older than 45 years old.
- Women who experience persistent symptoms may need to have a hysterectomy after a uterine artery embolization. Younger patients are more likely to experience recurrent symptoms.
What to expect during uterine artery embolization
During a uterine artery embolization, you will be awake but given medication that will enable you to relax. In order to clearly see the pelvic area during a uterine artery embolization, your doctor will use a fluoroscope to produce moving images and display them on a computer monitor.
Your surgeon will make an incision through the skin over the femoral artery (the vessel that passes through the groin area) and insert a catheter into the artery. Your surgeon will guide the catheter into a uterine artery and inject a contrast fluid to make them visible on the fluoroscope monitor. Fibroids will show up more vividly than other healthy uterine tissue. When the correct area of the uterine artery is located, the surgeon will inject particles made of plastic or gelatin into the vessel. These particles will block the fibroid vessels, causing them to eventually shrink and die. Your surgeon may need to perform these steps in the second uterine artery to completely eliminate the troublesome fibroids.
Recovery from uterine artery embolization
It will take approximately seven to 10 days to fully recover from a uterine artery embolization. You may experience pain, cramping, nausea, bleeding or develop a fever in the days after the procedure. You will start feeling better gradually. Notify your doctor if the symptoms become severe.
Your menstrual cycle may be heavier than normal for a few cycles, and you could pass fibroid tissue for as long as three months after the procedure.
Your doctor will outline how quickly you can resume your daily routine. Do not lift anything heavy for at least a week.