What is Uterine Fibroid Embolization?

Uterine Fibroid Embolization (UFE) is a minimally invasive, non-surgical procedure used to treat uterine fibroids – a type of tumor that grows in the uterus. While these tumors are non-cancerous, they can cause troublesome and disruptive symptoms like heavy menstrual bleeding, abdominal pain/pressure as well as urinary and other symptoms.

Signs and symptoms of uterine fibroids may include:

• Heavy and long menstrual bleeding
• Passage of large clots during menstrual period
• Bleeding in between periods
• Abdominal or pelvic pain / pressure
• Back pain
• Pain during sexual intercourse
• Abnormally enlarged abdomen
• Frequent urge to urinate
• Urinary incontinence
• Constipation
• Bloating

In the U.S., uterine fibroids are surprisingly common:

• 70% percent of women over the age of 35 years will develop uterine fibroids
• Most fibroids are diagnosed and treated in women of age 30 - 50
• However, fibroids can and do occur in women as young as 20+

If you are among the women affected by the symptoms of uterine fibroids, the University of Miami Interventional Radiology team has extensive experience in treating uterine fibroids with UFE.

Uterine Fibroid Embolization

Uterine fibroid embolization is performed by a physician called an Interventional Radiologist (IR). The procedure is performed through a small puncture in the wrist or groin.

A catheter is inserted through the artery and advanced towards the uterus. Once the catheter is positioned in the artery supplying blood to the uterine fibroids, tiny particles are injected.

These particles are tiny spheres which are smaller than grains of sand. These particles get stuck in the small branches supplying blood to the uterine fibroids, blocking blood flow. The blockage of these branches is called embolization.

The procedure is then repeated on the other side of the uterus. The procedure can take anywhere from 1 – 2.5 hours, depending on the location and size of the uterine arteries. Most women will not feel any pain during the procedure, except a minor pinch at the access point in the wrist or the groin. Some women do feel abdominal cramping or heaviness towards the end of the procedure, however pain medication is given before, during and after the procedure, to prevent and/or decrease these symptoms.

During the procedure, sedatives and pain killers (like Versed and Fentanyl) are used to alleviate anxiety, however patients are awake during the procedure. Patients usually stay up to 23 hours after the procedure is complete. You can resume your normal activities as early as the day after the procedure and patients usually return to work in 3-7 days.

How effective is UFE?

UFE has been shown to be equally effective as hysterectomy (surgical removal of uterus) for symptom relief by multiple studies.

Who is a Candidate for UFE?

If you suffer from the painful and disruptive symptoms of Uterine Fibroids, UFE may be the right option for you. Your gynecologist can provide a referral to an interventional radiologist who can help you decide, based on the number and size of your fibroids as well as your medical history and treatment goals, if UFE is right for you.

Patients who are ideal for UFE include women who have symptomatic fibroids, and:

• Want to keep their uterus
• Want to avoid medications that may bring about early menopause
• Do not want surgery
• May not be good candidates for surgery
• Prefer a short hospital stay

Discover the Advantages of UFE

UFE blocks the blood supply to the fibroids and helps to shrink it. This helps to ease both bleeding and bulky painful symptoms of fibroids, improving quality of life. Women who’ve undergone UFE report experiencing a high degree of satisfaction.

A number of benefits:

• Minimally invasive procedure
• As effective as hysterectomy (surgical removal of uterus)
• Post-procedure, most women go home after 23 hours
• Resume your normal activities as early as the day after the procedure
• Return to work in as early as 3 days
• No large incision or scar
• Less than 2% complication rate
• Relieves bleeding symptoms and symptoms related to the large size of fibroids (abdominal pain / pressure, excessive cramping, back pain, leg pain, discomfort during intercourse, urinary frequency, constipation)

What to Expect

Before treatment

You will visit the UHealth Interventional Radiology clinic and your interventional radiologist (IR) will explain the procedure in detail. They will discuss your fibroids – their size and location – as well as your specific goals of treatment, including your symptoms, recovery time and maintaining fertility.

You may be asked by your IR to see your obstetrician-gynecologist for testing prior to the procedure.

During your visit please be sure to let your doctor know if you are allergic to any medications, shellfish, iodine, contrast agents, or gelatin to minimize the risk of a reaction as a result of the fibroid treatment procedure.

You and your doctor also should decide what type of sedation will work best for you. Most doctors use conscious sedation, which means you will be awake during the procedure but you will feel groggy.

UFE treatment

UFE is performed in a hospital with sedatives and local anesthesia and general anesthesia is usually not required. The procedure typically requires a hospital stay up to 23 hours.

After you arrive at the hospital, you will be prepped for the procedure by the radiology staff. This includes initiating the sedation and other medication discussed during your consult. Other medications to manage post-procedure discomfort are also begun at this time.

UFE is minimally invasive, requiring only a small nick in the skin. The procedure begins with a tiny incision (less than half inch) in your upper thigh or wrist to gain access to your arterial system. Using specialized X-ray equipment, your doctor, an Interventional Radiologist (IR) guides a catheter (a small hollow tube) to the vessels that supply blood to your fibroids.

Once the IR reaches these arteries, embolic material (small particles less than the size of a grain of sand) are injected through the catheter. They block blood flow to the fibroids. The IR then repositions the catheter in order to treat the other side of the uterus. The particles block blood flow which causes the fibroids to shrink over time.

Once the IR has completed embolization of the uterine artery on both sides, the catheter is gently removed. The IR may close the incision using a vascular closure device.

After Treatment

You will be admitted for up to 23 hours during which time you will be monitored closely. At the end of this time, you will be discharged home with medications to help with any post-procedure discomfort. It is important to discuss with your IR which medications will be used in the management of your post-procedure care.

You will be contacted to follow up with your Interventional Radiologist in clinic, a few weeks after the procedure.

UFE and Fertility

Many women diagnosed with uterine fibroids are of child-bearing age. Maintaining or even improving the ability to have children plays a role in what treatment women choose for uterine fibroids.

While hysterectomy (surgical removal of the uterus) makes fertility impossible, during myomectomy (surgical removal of fibroids only) the uterus is usually left intact.

Likewise, during UFE the uterus usually remains intact. This is because fibroids within the uterus are the target of UFE, not the uterus itself.

Many women will maintain the ability to have children after UFE, but it is not guaranteed. One study found that half of women under the age of 40 who desired pregnancy after UFE treatment, were successful in having children. However, there is no conclusive scientific data that establishes the safety of UFE in regards to future fertility and pregnancy. Therefore, before choosing this fibroid treatment, it is very important that you understand the potential inability to conceive in the future.

If you are considering having children in the future, be sure to discuss your specific situation with the Interventional Radiologist you see in clinic before scheduling your procedure. They may have additional information specific to your case, that impacts which fibroid treatment option is best.

Less than 2% of patients have entered menopause as a result of UFE. This is more likely to occur if the woman is in her mid-forties or older and is already nearing menopause.

Why Choose UHealth?

Innovative, expert care for uterine fibroids. The Department of Interventional Radiology uses the latest research and the least invasive procedures to help you handle the troublesome symptoms of fibroids and recover quickly. Our team will help design a treatment plan, personalized to your needs and goals, to give you the safest and most effective treatment for fibroids.

Care designed with women in mind. Our Interventional Radiology team has experienced physicians offering care specific to women’s health issues. Our interventional radiologists work in collaboration with obstetricians and gynecologists who have expertise in treating uterine fibroids, as well as primary care physicians who provide research-backed care tailored to each woman. We help make care more convenient — offering advanced in-office procedures, the latest diagnostic tests for fast results, and access to comprehensive women’s health services for women of all ages — all in one location. Our highly-trained physicians and staff are sensitive to the needs of every woman, so you can feel comfortable and confident in your care and treatment.